| Danell Will, Lpc, Llc | |
|
1 W Sunbridge Dr Fayetteville AR 72703-1825 | |
| (479) 443-5575 | |
| Not Available |
| Full Name | Danell Will, Lpc, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1 W Sunbridge Dr, Fayetteville, Arkansas |
| Authorized Official Name and Position | Danell Will (OWNER) |
| Authorized Official Contact | 3086273612 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Danell Will, Lpc, Llc 1304 S 14th Pl Rogers AR 72758-5501 Ph: (308) 627-3612 | Danell Will, Lpc, Llc 1 W Sunbridge Dr Fayetteville AR 72703-1825 Ph: (479) 443-5575 |
| NPI Number | 1215403977 |
|---|---|
| Provider Enumeration Date | 10/22/2018 |
| Last Update Date | 06/11/2024 |
| Certification Date | 06/11/2024 |
| Medicare PECOS PAC ID | 7012451701 |
|---|---|
| Medicare Enrollment ID | O20240705001770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215403977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Danell Lee Will |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336630052 PECOS PAC ID: 8921542614 Enrollment ID: I20240705001971 |
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