Organization
NWA SECOND STAGE TRANSITION
Active
Other names
NWA Second Stage Transition
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CECELIA DORKO MASTER DEGREE (EXECUTIVE DIRECTOR)
(479) 547-3737
Entity
Organization
Contact information
Practice address
608 S HICO ST, SILOAM SPRINGS, AR 72761-3740
(479) 549-3737
Mailing address
608 S HICO ST, SILOAM SPRINGS, AR 72761-3740
(479) 549-3737
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
09/01/2021
Last updated
04/25/2022
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