Provider Demographics
NPI:1558698704
Name:ADVANCED COUNSELING AND NEUROFEEDBACK
Entity Type:Organization
Organization Name:ADVANCED COUNSELING AND NEUROFEEDBACK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DORAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC LMFT EDD
Authorized Official - Phone:501-207-3469
Mailing Address - Street 1:1120 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7319
Mailing Address - Country:US
Mailing Address - Phone:501-207-3469
Mailing Address - Fax:
Practice Address - Street 1:1120 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7319
Practice Address - Country:US
Practice Address - Phone:501-207-3469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR0002003101YM0800X
AR0007003106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty