Provider Demographics
NPI:1821157017
Name:CLINICAL & COMMUNITY PSYCHOLOGY & COUNSELING, P.A.
Entity Type:Organization
Organization Name:CLINICAL & COMMUNITY PSYCHOLOGY & COUNSELING, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:B
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:479-442-2457
Mailing Address - Street 1:301 W MOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-5947
Mailing Address - Country:US
Mailing Address - Phone:479-442-2457
Mailing Address - Fax:479-442-0159
Practice Address - Street 1:301 W MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5947
Practice Address - Country:US
Practice Address - Phone:479-442-2457
Practice Address - Fax:479-442-0159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8109P103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5S426OtherBCBS CLARK MILLIGAN
AR56528OtherBCBS FRANCES WOODS
AR56528OtherBCBS FRANCES WOODS