Provider Demographics
NPI:1922718295
Name:COUNSLING PLACE, LLC
Entity Type:Organization
Organization Name:COUNSLING PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-403-4878
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:870-230-0898
Mailing Address - Fax:
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:870-403-4878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health