Organization
BLACK BOX COUNSELING AND THERAPEUTIC SERVICES
Active
Other names
Blaqk Box
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH WHELLER EDS, LPC (MANAGING MEMBER)
(870) 530-5739
Entity
Organization
Contact information
Practice address
1000 S CARAWAY RD STE 103, JONESBORO, AR 72401-4465
(870) 530-5739
(844) 908-2206
Mailing address
912 POPLAR AVE, JONESBORO, AR 72401-3852
(870) 530-5739
(844) 908-2206
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922443993
—
AR
Enumeration date
07/09/2020
Last updated
09/14/2020
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