Provider Demographics
NPI:1639492911
Name:ARKANSAS ATTACHMENT & COUNSELING
Entity Type:Organization
Organization Name:ARKANSAS ATTACHMENT & COUNSELING
Other - Org Name:SUSAN D. WALKER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT
Authorized Official - Phone:479-366-7920
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:CAVE SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72718-0346
Mailing Address - Country:US
Mailing Address - Phone:479-366-7920
Mailing Address - Fax:
Practice Address - Street 1:1821 S 8TH ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-5912
Practice Address - Country:US
Practice Address - Phone:479-366-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0403014101YM0800X
ARM0501001106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR177690719Medicaid
AR5Y019OtherBLUE CROSS AND BLUE SHIELD