Provider Demographics
NPI:1891186656
Name:ARK COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:ARK COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:NUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:913-294-9175
Mailing Address - Street 1:310 N HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-1304
Mailing Address - Country:US
Mailing Address - Phone:913-294-9175
Mailing Address - Fax:
Practice Address - Street 1:310 N HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1304
Practice Address - Country:US
Practice Address - Phone:913-294-9175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty