Freeport Counseling Services, Llc | |
506 Coachlight Dr Bentonville AR 72712-5452 | |
(815) 297-3280 | |
Not Available |
Full Name | Freeport Counseling Services, Llc |
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Speciality | Counselor |
Location | 506 Coachlight Dr, Bentonville, Arkansas |
Authorized Official Name and Position | Colleen Marie Williamson (PRESIDENT) |
Authorized Official Contact | 8152973280 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Freeport Counseling Services, Llc 506 Coachlight Dr Bentonville AR 72712-5452 Ph: (815) 297-3280 | Freeport Counseling Services, Llc 506 Coachlight Dr Bentonville AR 72712-5452 Ph: (815) 297-3280 |
NPI Number | 1619116886 |
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Provider Enumeration Date | 02/11/2009 |
Last Update Date | 03/19/2025 |
Certification Date | 03/19/2025 |
Medicare PECOS PAC ID | 7517319304 |
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Medicare Enrollment ID | O20240117002412 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619116886 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 180.006894 (Illinois) | Primary |
Provider Name | Colleen Marie Williamson |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1255578019 PECOS PAC ID: 9335591122 Enrollment ID: I20240117002630 |
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