Basic Information
| Provider Information | |||||||||
| NPI: | 1689605115 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COUNSELING CONSULTANTS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1825 E BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | FORREST CITY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723353409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8706302328 | ||||||||
| FaxNumber: | 8706302348 | ||||||||
| Practice Location | |||||||||
| Address1: | 1825 E BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | FORREST CITY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723353409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8706302328 | ||||||||
| FaxNumber: | 8706302348 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BOSCHERT | ||||||||
| AuthorizedOfficialFirstName: | JEANNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8707396818 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | AR | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.