Provider Demographics
NPI:1457004202
Name:TRUE SELF THERAPY, P-LLC
Entity Type:Organization
Organization Name:TRUE SELF THERAPY, P-LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:AMANDA
Authorized Official - Last Name:FRIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-808-7511
Mailing Address - Street 1:5506 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3412
Mailing Address - Country:US
Mailing Address - Phone:404-808-7511
Mailing Address - Fax:855-877-0663
Practice Address - Street 1:5506 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3412
Practice Address - Country:US
Practice Address - Phone:404-808-7511
Practice Address - Fax:855-877-0663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR2607-COtherSOCIAL WORK LICENSING BOARD NUMBER
ARE6917OtherBCBS FILING ID