Provider Demographics
NPI:1790174019
Name:ABOUND PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:ABOUND PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ETCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPE-I
Authorized Official - Phone:501-868-4900
Mailing Address - Street 1:16623 CANTRELL RD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4247
Mailing Address - Country:US
Mailing Address - Phone:501-868-4900
Mailing Address - Fax:501-868-4901
Practice Address - Street 1:16623 CANTRELL RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4247
Practice Address - Country:US
Practice Address - Phone:501-868-4900
Practice Address - Fax:501-868-4901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR05-06EI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty