| Soul Spark Counseling, Llc | |
|
128 Southwinds Rd Farmington AR 72730-8678 | |
| (479) 222-1156 | |
| Not Available |
| Full Name | Soul Spark Counseling, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 128 Southwinds Rd, Farmington, Arkansas |
| Authorized Official Name and Position | Tessa Renee Vanderhorn (INCORPORATOR/ORGANIZER) |
| Authorized Official Contact | 5093061102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Spark Counseling, Llc Po Box 1121 Prairie Grove AR 72753-1121 Ph: (479) 222-1156 | Soul Spark Counseling, Llc 128 Southwinds Rd Farmington AR 72730-8678 Ph: (479) 222-1156 |
| NPI Number | 1407632334 |
|---|---|
| Provider Enumeration Date | 09/06/2023 |
| Last Update Date | 09/06/2023 |
| Certification Date | 09/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407632334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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