Organization
COUNSELING CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BENNETT LCSW (CEO)
(501) 315-4224
Entity
Organization
Contact information
Practice address
110 PEARSON, BENTON, AR 72015-4436
(501) 315-4224
(501) 778-0450
Mailing address
110 PEARSON, BENTON, AR 72015-4436
(501) 315-4224
(501) 778-0450
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116381726
—
AR
Enumeration date
10/04/2005
Last updated
08/30/2023
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