Organization
MIND AND BODY WELLNESS, LLC.
Active
Other names
Mind and Body Wellness, LLC.
Organization subpart
No
Provider details
NPI number
Authorized official
LUCINDA J SHEPHERD (OWNER)
(479) 409-6049
Entity
Organization
Contact information
Practice address
720 LEXINGTON AVE, FORT SMITH, AR 72901-4738
(479) 910-3169
(479) 600-5051
Mailing address
PO BOX 6632, SPRINGDALE, AR 72766-6632
(479) 409-6049
(479) 600-5051
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
322060002
—
AR
Enumeration date
06/14/2023
Last updated
08/06/2024
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