Provider Demographics
NPI:1083403430
Name:LIVE WELL COUNSELING
Entity type:Organization
Organization Name:LIVE WELL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-900-2703
Mailing Address - Street 1:1845 N GREEN ACRES RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2615
Mailing Address - Country:US
Mailing Address - Phone:479-713-9879
Mailing Address - Fax:
Practice Address - Street 1:1845 N GREEN ACRES RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2615
Practice Address - Country:US
Practice Address - Phone:479-900-2703
Practice Address - Fax:855-595-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)