Provider Demographics
NPI:1720582307
Name:LAMPSTEAD COUNSELING LLC
Entity Type:Organization
Organization Name:LAMPSTEAD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KENYON
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:MOSHER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LADAC
Authorized Official - Phone:580-541-6416
Mailing Address - Street 1:2503 PINE ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-4368
Mailing Address - Country:US
Mailing Address - Phone:580-541-6416
Mailing Address - Fax:877-276-1301
Practice Address - Street 1:2503 PINE ST STE 4
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4368
Practice Address - Country:US
Practice Address - Phone:580-541-6416
Practice Address - Fax:877-276-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty