| Riverbase Counseling Clinic Pllc | |
|
2405 Villa Dr Ozark AR 72949-9452 | |
| (479) 214-4319 | |
| Not Available |
| Full Name | Riverbase Counseling Clinic Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2405 Villa Dr, Ozark, Arkansas |
| Authorized Official Name and Position | Lindsey Fultz (MANAGER) |
| Authorized Official Contact | 4792144319 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverbase Counseling Clinic Pllc 2405 Villa Dr Ozark AR 72949-9452 Ph: (479) 214-4319 | Riverbase Counseling Clinic Pllc 2405 Villa Dr Ozark AR 72949-9452 Ph: (479) 214-4319 |
| NPI Number | 1790678894 |
|---|---|
| Provider Enumeration Date | 05/29/2025 |
| Last Update Date | 05/29/2025 |
| Certification Date | 05/29/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790678894 | NPI | - | NPPES |
| P1701221 | Other | AR | LPC |
| 14028085 | Other | AR | CAQH |
| 1861785578 | Other | AR | NPI |
| 322059795 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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