COUNSELING SERVICES OF JACKSONVILLE PA NPI 1215955638

NPI Information

COUNSELING SERVICES OF JACKSONVILLE PA is a mental health counselor in Jacksonville, AR. COUNSELING SERVICES OF JACKSONVILLE PA NPI is 1215955638. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

707 S 1ST ST
JACKSONVILLE, AR
ZIP 72076
Phone: (501) 985-0292
Fax: (501) 985-2070

The provider's authorized official is James Randall Walker .
The authorized official title is Owner Clinical Director and has the following contact phone number (501) 985-0292.

The CLIA number assigned to this NPI record is 04D2178242 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/17/2006 and was last updated on 8/22/2020.

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:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.