| Fulfilled Life Counseling, Llc | |
|
1218 Stone St Ste 204 Jonesboro AR 72401-4568 | |
| (901) 501-6091 | |
| (870) 466-4982 |
| Full Name | Fulfilled Life Counseling, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1218 Stone St Ste 204, Jonesboro, Arkansas |
| Authorized Official Name and Position | Leonardo Patrick Glover (CEO) |
| Authorized Official Contact | 8707186199 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fulfilled Life Counseling, Llc 4609 Summit Ridge Dr Jonesboro AR 72404-9101 Ph: (870) 718-6199 | Fulfilled Life Counseling, Llc 1218 Stone St Ste 204 Jonesboro AR 72401-4568 Ph: (901) 501-6091 |
| NPI Number | 1932762754 |
|---|---|
| Provider Enumeration Date | 04/17/2019 |
| Last Update Date | 04/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932762754 | NPI | - | NPPES |
| 1093088031 | Other | AR | QUALCHOICE |
| 1093088031 | Other | AR | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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