Provider Demographics
NPI:1356867303
Name:CENTRAL ARKANSAS GROUP COUNSELING, PLLC
Entity Type:Organization
Organization Name:CENTRAL ARKANSAS GROUP COUNSELING, PLLC
Other - Org Name:ARKANSAS COUNSELING AND WELLNESS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-S, AADC
Authorized Official - Phone:501-205-4570
Mailing Address - Street 1:PO BOX 2129
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-2129
Mailing Address - Country:US
Mailing Address - Phone:501-205-4570
Mailing Address - Fax:888-305-8084
Practice Address - Street 1:4702 W COMMERCIAL DR STE B3
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7073
Practice Address - Country:US
Practice Address - Phone:501-205-4570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-21
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)