Provider Demographics
NPI:1881197697
Name:NWA CHRISTIAN COUNSELING GROUP, INC. DBA BROOKWAY COUNSELING
Entity Type:Organization
Organization Name:NWA CHRISTIAN COUNSELING GROUP, INC. DBA BROOKWAY COUNSELING
Other - Org Name:BROOKWAY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AM
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEULS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-571-0867
Mailing Address - Street 1:801 CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-5105
Mailing Address - Country:US
Mailing Address - Phone:479-466-3783
Mailing Address - Fax:855-277-8988
Practice Address - Street 1:801 CARLTON ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-5105
Practice Address - Country:US
Practice Address - Phone:479-255-5414
Practice Address - Fax:855-277-8988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-18
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1258-C1041C0700X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty