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Organization
FOUNDATION: A WELLNESS PRACTICE, LLC
Active
Organization
FOUNDATION: A WELLNESS PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI LANELL WHITE LCSW (OWNER)
(573) 344-0976
Entity
Organization
Contact information
Practice address
533 W WASHINGTON AVE, JONESBORO, AR 72401
(870) 229-0302
(870) 520-6482
Mailing address
533 W WASHINGTON AVE, JONESBORO, AR 72401-2782
(870) 229-0302
(870) 520-6482
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
Other
Enumeration date
04/20/2018
Last updated
09/28/2018
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