1336508316 NPI number — CHRISTIAN PERSPECTIVE COUNSELING, INC.

Table of content: (NPI 1336508316)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336508316 NPI number — CHRISTIAN PERSPECTIVE COUNSELING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTIAN PERSPECTIVE COUNSELING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336508316
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 344
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONWAY
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72033-0344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-450-6350
Provider Business Mailing Address Fax Number:
501-358-4932

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 SALEM RD
Provider Second Line Business Practice Location Address:
SUITE #3
Provider Business Practice Location Address City Name:
CONWAY
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72034-6162
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-450-6350
Provider Business Practice Location Address Fax Number:
501-358-4932
Provider Enumeration Date:
02/18/2016

Additional Information

Authorized Official

Authorized Official Last Name:
PRIEST
Authorized Official First Name:
JON
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, THERAPIST
Authorized Official Telephone Number:
501-450-6350

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  A1401010 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC1900X , with the licence number: 09-19EI , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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