Provider Demographics
NPI:1568298446
Name:CBULLARD COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:CBULLARD COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BULLARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-489-5454
Mailing Address - Street 1:PO BOX 1251
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71613-1251
Mailing Address - Country:US
Mailing Address - Phone:870-489-4177
Mailing Address - Fax:
Practice Address - Street 1:7958 HIGHWAY 79 S
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-4541
Practice Address - Country:US
Practice Address - Phone:870-489-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty