Provider Demographics
NPI:1629650296
Name:STEPHANIE GULLEY, LPC, PLLC
Entity Type:Organization
Organization Name:STEPHANIE GULLEY, LPC, PLLC
Other - Org Name:STEPHANIE HUNTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-926-2067
Mailing Address - Street 1:627 W PARKER RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-8572
Mailing Address - Country:US
Mailing Address - Phone:870-926-2067
Mailing Address - Fax:
Practice Address - Street 1:627 W PARKER RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-8572
Practice Address - Country:US
Practice Address - Phone:870-926-2067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty