Provider Demographics
NPI:1770321630
Name:CARAWAY COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:CARAWAY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LCSW
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:CARAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:870-213-8769
Mailing Address - Street 1:210 E 7TH ST
Mailing Address - Street 2:SUITE 3, OFFICE A
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653
Mailing Address - Country:US
Mailing Address - Phone:870-213-8769
Mailing Address - Fax:877-940-2531
Practice Address - Street 1:210 E 7TH ST
Practice Address - Street 2:SUITE 3, OFFICE A
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653
Practice Address - Country:US
Practice Address - Phone:870-213-8769
Practice Address - Fax:877-940-2531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty