Provider Demographics
NPI:1043783079
Name:FREEMAN-BURCHFIELD AND WELLES INSTITUTE OF COGNITIVE BEHAVIORAL THERAP
Entity Type:Organization
Organization Name:FREEMAN-BURCHFIELD AND WELLES INSTITUTE OF COGNITIVE BEHAVIORAL THERAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:479-282-4452
Mailing Address - Street 1:5210 W VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8104
Mailing Address - Country:US
Mailing Address - Phone:479-372-7446
Mailing Address - Fax:479-802-4765
Practice Address - Street 1:5210 W VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8104
Practice Address - Country:US
Practice Address - Phone:479-372-7446
Practice Address - Fax:479-802-4765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)