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Individual

PETER MCCOLLOUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
QBHP

Contact information

Practice address
5111 ROGERS AVE, FORT SMITH, AR 72903-2047
(479) 222-0268
Mailing address
5111 ROGERS AVE, FORT SMITH, AR 72903-2047
(479) 927-1373

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
AR
106S00000X
Behavior Technician
Primary
AR
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
307022706
AR
Enumeration date
01/05/2021
Last updated
02/11/2026
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