Provider Demographics
NPI:1215681762
Name:EPOCH COUNSELING & CONSULTING, PLLC
Entity type:Organization
Organization Name:EPOCH COUNSELING & CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:TIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:501-428-0935
Mailing Address - Street 1:402 SE FULLERTON ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4135
Mailing Address - Country:US
Mailing Address - Phone:501-428-3902
Mailing Address - Fax:
Practice Address - Street 1:5310 W VILLAGE PKWY STE 4
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8201
Practice Address - Country:US
Practice Address - Phone:501-428-0935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty