Provider Demographics
NPI:1588357768
Name:REFRAME FAMILY THERAPY LLC
Entity type:Organization
Organization Name:REFRAME FAMILY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST; OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BACON-LATINA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT
Authorized Official - Phone:501-802-0107
Mailing Address - Street 1:1910 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-6041
Mailing Address - Country:US
Mailing Address - Phone:501-802-0107
Mailing Address - Fax:
Practice Address - Street 1:1910 SHADY LN
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-6041
Practice Address - Country:US
Practice Address - Phone:501-802-0107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health