Provider Demographics
NPI:1023414885
Name:STONE PATH COUNSELING, PLC
Entity type:Organization
Organization Name:STONE PATH COUNSELING, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:BORBON
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-225-8160
Mailing Address - Street 1:130 E POPLAR ST STE C
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2573
Mailing Address - Country:US
Mailing Address - Phone:479-435-6047
Mailing Address - Fax:479-755-3595
Practice Address - Street 1:130 E POPLAR ST STE C
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-435-6047
Practice Address - Fax:479-755-3595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty