Provider Demographics
NPI:1710756127
Name:DB PLLC
Entity Type:Organization
Organization Name:DB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-561-0108
Mailing Address - Street 1:3308 S 54TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4617
Mailing Address - Country:US
Mailing Address - Phone:479-561-0108
Mailing Address - Fax:
Practice Address - Street 1:3017 S 70TH ST STE G
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5000
Practice Address - Country:US
Practice Address - Phone:479-210-2146
Practice Address - Fax:479-222-6895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty