Provider Demographics
NPI:1174195895
Name:BAUGH TARVER COUNSELING SERVICES
Entity Type:Organization
Organization Name:BAUGH TARVER COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:ALANA
Authorized Official - Last Name:HARRIS BRASHEARS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-370-1111
Mailing Address - Street 1:4257 N GABEL DR STE 1C
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5038
Mailing Address - Country:US
Mailing Address - Phone:870-370-1111
Mailing Address - Fax:
Practice Address - Street 1:1766 DUTCHESS PL
Practice Address - Street 2:
Practice Address - City:TONTITOWN
Practice Address - State:AR
Practice Address - Zip Code:72762-6209
Practice Address - Country:US
Practice Address - Phone:187-037-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty