Provider Demographics
NPI:1366950958
Name:CONNECTIONS COUNSELING CENTER
Entity type:Organization
Organization Name:CONNECTIONS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-351-6100
Mailing Address - Street 1:2510 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BEND
Mailing Address - State:AR
Mailing Address - Zip Code:72512-5576
Mailing Address - Country:US
Mailing Address - Phone:870-351-6100
Mailing Address - Fax:870-750-2199
Practice Address - Street 1:2510 CRESCENT DR
Practice Address - Street 2:
Practice Address - City:HORSESHOE BEND
Practice Address - State:AR
Practice Address - Zip Code:72512-5576
Practice Address - Country:US
Practice Address - Phone:870-351-6100
Practice Address - Fax:870-750-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
ARP1109069101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty