| Dallas Counseling Llc | |
|
2013 N Green Acres Rd Ste D Fayetteville AR 72703-2600 | |
| (479) 462-7324 | |
| Not Available |
| Full Name | Dallas Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2013 N Green Acres Rd Ste D, Fayetteville, Arkansas |
| Authorized Official Name and Position | Lauren Dallas (OWNER) |
| Authorized Official Contact | 4792495805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Counseling Llc 2013 N Green Acres Rd Ste D Fayetteville AR 72703-2600 Ph: (479) 462-7324 | Dallas Counseling Llc 2013 N Green Acres Rd Ste D Fayetteville AR 72703-2600 Ph: (479) 462-7324 |
| NPI Number | 1568138238 |
|---|---|
| Provider Enumeration Date | 08/21/2021 |
| Last Update Date | 09/14/2021 |
| Certification Date | 09/14/2021 |
| Medicare PECOS PAC ID | 5597163659 |
|---|---|
| Medicare Enrollment ID | O20211005000896 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568138238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lauren C Dallas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922603653 PECOS PAC ID: 6204234362 Enrollment ID: I20211005001171 |
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