Provider Demographics
NPI:1629654025
Name:THE DARING SPACE - A PRIVATE THERAPY PRACTICE
Entity Type:Organization
Organization Name:THE DARING SPACE - A PRIVATE THERAPY PRACTICE
Other - Org Name:THE DARING SPACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JENNINGS-HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-375-2042
Mailing Address - Street 1:15 SHANNON DR
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-2536
Mailing Address - Country:US
Mailing Address - Phone:870-253-1570
Mailing Address - Fax:
Practice Address - Street 1:203 MERRIMAN AVE E
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-2943
Practice Address - Country:US
Practice Address - Phone:870-375-2042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty