Provider Demographics
NPI:1104692193
Name:CARE COUNSELING SERVICES
Entity type:Organization
Organization Name:CARE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:STIDUM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:501-412-0069
Mailing Address - Street 1:9214 TALL TIMBER BLVD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-8523
Mailing Address - Country:US
Mailing Address - Phone:501-247-0252
Mailing Address - Fax:501-712-4534
Practice Address - Street 1:217 W 2ND ST STE 306
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-2522
Practice Address - Country:US
Practice Address - Phone:501-412-0049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty