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Organization
PSYCHOLOGICAL CARE CENTER
Active
Organization
PSYCHOLOGICAL CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE M DEROECK PSY.D. (PSYCHOLOGIST)
(870) 972-4770
Entity
Organization
Contact information
Practice address
308 W MONROE AVE, JONESBORO, AR 72401-2741
(870) 972-4770
Mailing address
308 W MONROE AVE, JONESBORO, AR 72401-2741
(870) 972-4770
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E3022
ELECTRONIC SUBMITTER #
AR
Enumeration date
02/28/2007
Last updated
08/22/2020
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