Provider Demographics
NPI:1598597155
Name:MISTY MCARTHUR COUNSELING AND WELLNESS, LLC
Entity type:Organization
Organization Name:MISTY MCARTHUR COUNSELING AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-243-6468
Mailing Address - Street 1:2005 SE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-5922
Mailing Address - Country:US
Mailing Address - Phone:575-937-4673
Mailing Address - Fax:
Practice Address - Street 1:2810 SUDDERTH DR STE 210
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6307
Practice Address - Country:US
Practice Address - Phone:575-937-4673
Practice Address - Fax:575-213-4886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)