Basic Information
| Provider Information | |||||||||
| NPI: | 1144606567 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CROY | ||||||||
| FirstName: | AARON | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 SALEM RD | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | CONWAY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720347525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013368300 | ||||||||
| FaxNumber: | 4798905364 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 SKYLINE DR | ||||||||
| Address2: | |||||||||
| City: | RUSSELLVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4799675570 | ||||||||
| FaxNumber: | 4798905364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2015 | ||||||||
| LastUpdateDate: | 07/09/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | P1807085 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.