Provider Demographics
NPI:1033569579
Name:ARKANSAS RELATIONSHIP COUNSELING CENTER
Entity Type:Organization
Organization Name:ARKANSAS RELATIONSHIP COUNSELING CENTER
Other - Org Name:RENWED MINDS THERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:III
Authorized Official - Credentials:LMFT, LPC
Authorized Official - Phone:501-313-1185
Mailing Address - Street 1:4 SHACKLEFORD PLZ
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-1826
Mailing Address - Country:US
Mailing Address - Phone:501-313-1185
Mailing Address - Fax:501-421-9403
Practice Address - Street 1:4 SHACKLEFORD PLZ
Practice Address - Street 2:SUITE 202
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-1826
Practice Address - Country:US
Practice Address - Phone:501-313-1185
Practice Address - Fax:501-421-9403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1310099101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty