Provider Demographics
NPI:1831650720
Name:UNIQUELY INTEGRATED COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:UNIQUELY INTEGRATED COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAMBRHEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-651-0349
Mailing Address - Street 1:3614 EDINBURGH DR
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-8061
Mailing Address - Country:US
Mailing Address - Phone:501-651-0349
Mailing Address - Fax:510-405-0148
Practice Address - Street 1:3614 EDINBURGH DR
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-8061
Practice Address - Country:US
Practice Address - Phone:501-651-0349
Practice Address - Fax:510-405-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty