| Bella Vista Counseling | |
|
1801 Forest Hills Blvd Ste 121 Bella Vista AR 72715-3070 | |
| (479) 721-3835 | |
| Not Available |
| Full Name | Bella Vista Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 1801 Forest Hills Blvd Ste 121, Bella Vista, Arkansas |
| Authorized Official Name and Position | Kelly K Wilson (OWNER/LCSW) |
| Authorized Official Contact | 4797213835 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bella Vista Counseling 1801 Forest Hills Blvd Ste 121 Bella Vista AR 72715-3070 Ph: (479) 721-3835 | Bella Vista Counseling 1801 Forest Hills Blvd Ste 121 Bella Vista AR 72715-3070 Ph: (479) 721-3835 |
| NPI Number | 1053146092 |
|---|---|
| Provider Enumeration Date | 09/06/2024 |
| Last Update Date | 09/06/2024 |
| Certification Date | 09/06/2024 |
| Medicare PECOS PAC ID | 9638603178 |
|---|---|
| Medicare Enrollment ID | O20241106003847 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053146092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelly Kendra Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902345416 PECOS PAC ID: 6901228964 Enrollment ID: I20200619000856 |
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