# WOOLVERTON INSTITUTE FOR PSYCHOTHERAPY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Village Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205113222
- **Authorized official:** FREDERICK WOOLVERTON PH.D. (DIRECTOR)
- **Authorized official phone:** (479) 442-4080

## Contact information

- **Practice address:** 21 W MOUNTAIN ST, SUITE 300, FAYETTEVILLE, AR 72701-6086
- **Practice address phone:** (479) 442-4080
- **Practice address fax:** (212) 253-4136
- **Mailing address:** 21 W MOUNTAIN ST, SUITE 300, FAYETTEVILLE, AR 72701-6086
- **Mailing address phone:** (479) 442-4080
- **Mailing address fax:** (212) 253-4136

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | 04-19P | AR | Yes |

## Other

- **Enumeration date:** 11/03/2011
- **Last updated:** 11/03/2011