Provider Demographics
NPI:1427540210
Name:ROADMAPS COUNSELING AND MEDIATION, INC.
Entity Type:Organization
Organization Name:ROADMAPS COUNSELING AND MEDIATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MATLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-424-0570
Mailing Address - Street 1:PO BOX 2261
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72654-2261
Mailing Address - Country:US
Mailing Address - Phone:870-424-0570
Mailing Address - Fax:844-272-9266
Practice Address - Street 1:911 S BAKER ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-4711
Practice Address - Country:US
Practice Address - Phone:870-424-0570
Practice Address - Fax:844-272-9266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)