| Tkw Counseling Service, Llc | |
|
15 E 5th St Mountain Home AR 72653-3809 | |
| (945) 328-7170 | |
| (314) 667-3621 |
| Full Name | Tkw Counseling Service, Llc |
|---|---|
| Speciality | Counselor |
| Location | 15 E 5th St, Mountain Home, Arkansas |
| Authorized Official Name and Position | Keith L. White (CEO/BUSINESS MANAGER) |
| Authorized Official Contact | 4179428230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tkw Counseling Service, Llc 1404 Southern Hills Drive Pmb400 West Plains MO 65775 Ph: (945) 328-7170 | Tkw Counseling Service, Llc 15 E 5th St Mountain Home AR 72653-3809 Ph: (945) 328-7170 |
| NPI Number | 1326815986 |
|---|---|
| Provider Enumeration Date | 12/05/2023 |
| Last Update Date | 12/05/2023 |
| Certification Date | 12/05/2023 |
| Medicare PECOS PAC ID | 0840649729 |
|---|---|
| Medicare Enrollment ID | O20231218003289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326815986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Teresa Kay White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073751301 PECOS PAC ID: 1759730633 Enrollment ID: I20231218004209 |
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