Provider Demographics
NPI:1386193985
Name:HOLISTIC COUNSELING & CONSULTING, PLLC
Entity Type:Organization
Organization Name:HOLISTIC COUNSELING & CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWONDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BROWN-IRBY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:501-744-4918
Mailing Address - Street 1:7101 W 12TH ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-2404
Mailing Address - Country:US
Mailing Address - Phone:501-400-8077
Mailing Address - Fax:501-400-8077
Practice Address - Street 1:7101 W 12TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-2404
Practice Address - Country:US
Practice Address - Phone:501-400-8077
Practice Address - Fax:501-400-8077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-25
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1609132101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1558752634Medicaid