Provider Demographics
NPI:1699105841
Name:PHILLIPS CLIENT SERVICES INC.
Entity type:Organization
Organization Name:PHILLIPS CLIENT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:JEFFERY
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-747-0137
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-0456
Mailing Address - Country:US
Mailing Address - Phone:479-747-0137
Mailing Address - Fax:866-596-4582
Practice Address - Street 1:1110 W B ST
Practice Address - Street 2:SUITE G
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-3506
Practice Address - Country:US
Practice Address - Phone:479-747-0137
Practice Address - Fax:866-596-4582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-24
Last Update Date:2013-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9702005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty