Provider Demographics
NPI:1124716493
Name:MOUNTAIN CREEK COUNSELING, LLC
Entity type:Organization
Organization Name:MOUNTAIN CREEK COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-733-8118
Mailing Address - Street 1:1242 RIVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:AR
Mailing Address - Zip Code:72835-7009
Mailing Address - Country:US
Mailing Address - Phone:479-477-4140
Mailing Address - Fax:
Practice Address - Street 1:1110 W B ST STE H
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-3506
Practice Address - Country:US
Practice Address - Phone:479-733-8118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty