SERENITY AND SOUL COUNSELING LLC (NPI# 1760009716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760009716 |
| Entity Type | Organization |
| Organization Name | SERENITY AND SOUL COUNSELING LLC |
| Practice Address |
1202 Ne Mcclain Rd Ste 2002 Bentonville AR 72712-3875 |
| Mailing Address |
6152 W Pleasant Dr Rogers AR 72758-9556 |
| Practice Telephone | 4792571919 |
| Mailing Telephone | 4792571919 |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-06-25 |
| Authorized Official Name | CHARLOTTE EVANS (OWNER) |
| Authorized Official Telephone | 4792571919 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | LPC | 1497996243 | 01 |
| Street Address |
1202 NE MCCLAIN RD STE 2002 |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72712-3875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1295361509 | Unbridled Holdings LLC | Physical Therapy Assistant | 9900 Price Coffee Rd, Bentonville, AR 72712 | 2020-03-18 |
| 1649803552 | Hanna Kathryn Baxendale | Pediatrics | 2900 Medical Pkwy, Ste #370, Bentonville, AR 72712 | 2020-02-19 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1609352566 | Tripharma Inc | Pharmacy | 3500 Sw Regional Airport Blvd Ste 2, Bentonville, AR 72712 | 2018-07-13 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1023536836 | Charlotte Yuvonne Hoyle | Case Manager/Care Coordinator | 2005 S.e Walton Blvd., Bentonville, AR 72712 | 2017-08-31 |
| 1508399502 | Rosanna Nicole Rephan | Nurse Practitioner | 3101 14th St, Mercy Convenient Care, Bentonville, AR 72712 | 2017-04-06 |
| 1417305517 | Charlotte Lennette Stephenson | Behavioral Analyst | 2005 S.e. Walton Blvd., Bentonville, AR 72712 | 2016-05-31 |
| Find all providers in zip 72712 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1215571534 | Scott Francis Butler | Counselor | 305 Nw Palomino St, Bentonville, AR 72712-6472 | 2019-10-30 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1417495193 | Noel Christine Johnson | Counselor | 3909 Ne Nightingale, Bentonville, AR 72712-8903 | 2017-02-02 |
| 1992193361 | Lauren E Coles | Counselor | 809 Se 28th St Ste 1, Bentonville, AR 72712-4268 | 2015-01-07 |
| 1750714150 | William Burnett | Counselor | 2705 Se G St, Suite 9, Bentonville, AR 72712-3740 | 2013-08-21 |
| 1164795001 | Ronald Henderson | Counselor | 7807 Blue Jay Way, Bentonville, AR 72712-0000 | 2012-02-22 |
| 1184921603 | James Brandon Humphreys | Counselor | 108 E Central Ave Ste 210, Bentonville, AR 72712-5396 | 2011-02-18 |
| 1932416237 | Rebecca Choate Fancher | Counselor | 304 Se Eaton St, Bentonville, AR 72712-3923 | 2010-09-08 |
| Find all providers in BENTONVILLE | ||||
| City | BENTONVILLE |
| Zip Code | 72712 |
Please comment or provide details below to improve the information on SERENITY AND SOUL COUNSELING LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.