Individual
SPENCER MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
600 S TIMBERLANE DR, EL DORADO, AR 71730-6990
(870) 862-2400
(870) 862-1891
Mailing address
125 WELLNESS WAY, HOT SPRINGS, AR 71913-6478
(501) 624-7111
(501) 620-5109
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A1602028
AR
101YP2500X
Professional Counselor
Primary
P1710366
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218243795
—
AR
Enumeration date
04/05/2016
Last updated
07/15/2019
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