Provider Demographics
NPI:1194076737
Name:REHABILITATION & COUNSELING CONSULTANTS
Entity type:Organization
Organization Name:REHABILITATION & COUNSELING CONSULTANTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TRESVIL
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:PACK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CRC, LPC
Authorized Official - Phone:501-499-8699
Mailing Address - Street 1:PO BOX 11770
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-0031
Mailing Address - Country:US
Mailing Address - Phone:501-499-8699
Mailing Address - Fax:501-205-4588
Practice Address - Street 1:930 WINGATE ST STE D2
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4837
Practice Address - Country:US
Practice Address - Phone:501-499-8699
Practice Address - Fax:501-205-4588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-23
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1101006101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty