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WOODRIDGE OF WEST MEMPHIS LLC NPI 1033694906


NPI Information

NPI: 1033694906
Provider Name: WOODRIDGE OF WEST MEMPHIS, LLC

Doing Business As: WOODRIDGE COUNSELING CENTER

Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
800 S CHURCH ST STE 103
JONESBORO, AR
ZIP 72401
Phone: (470) 554-7903
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WOODRIDGE OF WEST MEMPHIS, LLC is an adolescent and children mental health clinic center in Jonesboro, AR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. WOODRIDGE OF WEST MEMPHIS, LLC NPI is 1033694906. The provider is registered as an organization entity type.
The provider Is Doing Business As Woodridge Counseling Center.

The provider's business location address is:

800 S CHURCH ST STE 103
JONESBORO, AR
ZIP 72401-154
Phone: (470) 554-7903

The provider's authorized official is Rochelle Gerber .
The authorized official title is Dir. Of Admin. Svcs and has the following contact phone number (470) 554-7903.

The enumeration date for this NPI number is 9/26/2018 and was last updated on 5/14/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2261QM0850XClinic/CenterAdult Mental HealthNo
3261QM0855XClinic/CenterAdolescent and Children Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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