Organization
BLACK BOX COUNSELING AND THERAPEUTIC SERVICES
Active
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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