Provider Demographics
NPI:1457035586
Name:CONNECTIONSNWA COUNSELING AND MORE, LLC
Entity Type:Organization
Organization Name:CONNECTIONSNWA COUNSELING AND MORE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:BRANT
Authorized Official - Last Name:CATES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:479-366-1129
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:GENTRY
Mailing Address - State:AR
Mailing Address - Zip Code:72734-0042
Mailing Address - Country:US
Mailing Address - Phone:479-366-1129
Mailing Address - Fax:479-525-5829
Practice Address - Street 1:108 CROSSOVER AVE STE C
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-8900
Practice Address - Country:US
Practice Address - Phone:479-366-1129
Practice Address - Fax:479-525-5829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health