Provider Demographics
NPI:1164931291
Name:PT CONCEPTS, PLLC
Entity Type:Organization
Organization Name:PT CONCEPTS, PLLC
Other - Org Name:WATERS EDGE COUNSELING PLAY THERAPY AND TRAINING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-621-0301
Mailing Address - Street 1:204 S 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1129
Mailing Address - Country:US
Mailing Address - Phone:479-621-0301
Mailing Address - Fax:479-866-6300
Practice Address - Street 1:204 S 24TH ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1129
Practice Address - Country:US
Practice Address - Phone:479-621-0301
Practice Address - Fax:479-866-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1103020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty