| Community Counseling Services, Inc. | |
|
1615 Martin Luther King Blvd Malvern AR 72104-2233 | |
| (501) 332-5236 | |
| (501) 620-5109 |
| Full Name | Community Counseling Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1615 Martin Luther King Blvd, Malvern, Arkansas |
| Authorized Official Name and Position | Robert Gershon (CEO) |
| Authorized Official Contact | 5016247111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Counseling Services, Inc. 125 Wellness Way Hot Springs AR 71913-6478 Ph: (501) 624-7111 | Community Counseling Services, Inc. 1615 Martin Luther King Blvd Malvern AR 72104-2233 Ph: (501) 332-5236 |
| NPI Number | 1972756419 |
|---|---|
| Provider Enumeration Date | 10/28/2008 |
| Last Update Date | 11/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972756419 | NPI | - | NPPES |
| 116399726 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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