| Experience Counseling Clinic, Inc. | |
|
1209 Ferguson Dr Benton AR 72015-3596 | |
| (870) 470-5001 | |
| Not Available |
| Full Name | Experience Counseling Clinic, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1209 Ferguson Dr, Benton, Arkansas |
| Authorized Official Name and Position | Kimberly Moore (OWNER/COO) |
| Authorized Official Contact | 8704745001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Experience Counseling Clinic, Inc. Po Box 932 Hope AR 71802-0932 Ph: () - | Experience Counseling Clinic, Inc. 1209 Ferguson Dr Benton AR 72015-3596 Ph: (870) 470-5001 |
| NPI Number | 1053198283 |
|---|---|
| Provider Enumeration Date | 09/11/2023 |
| Last Update Date | 09/11/2023 |
| Certification Date | 09/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053198283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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