Provider Demographics
NPI:1003633728
Name:SPRING RIVER COUNSELING, LLC
Entity type:Organization
Organization Name:SPRING RIVER COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-438-1515
Mailing Address - Street 1:343 W FIRETOWER RD
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-9444
Mailing Address - Country:US
Mailing Address - Phone:870-406-4705
Mailing Address - Fax:870-406-4725
Practice Address - Street 1:343 W FIRETOWER RD
Practice Address - Street 2:
Practice Address - City:HARDY
Practice Address - State:AR
Practice Address - Zip Code:72542-9444
Practice Address - Country:US
Practice Address - Phone:870-406-4705
Practice Address - Fax:870-406-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty