Provider Demographics
NPI:1669197133
Name:GARLAND COUNTY GRIEF COUNSELING
Entity type:Organization
Organization Name:GARLAND COUNTY GRIEF COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:865-242-0009
Mailing Address - Street 1:161 FOX CHASE CIR
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-9812
Mailing Address - Country:US
Mailing Address - Phone:865-242-0009
Mailing Address - Fax:
Practice Address - Street 1:320 OUACHITA AVE STE 202
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-5165
Practice Address - Country:US
Practice Address - Phone:865-242-0009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty