Organization
COLLABORATIVE COUNSELING ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA M FRESH LCSW (INCORPORATOR/ MANAGING MEMBER)
(501) 442-2293
Entity
Organization
Contact information
Practice address
1408 S SCHILLER ST, LITTLE ROCK, AR 72202-5817
(501) 507-0675
(501) 421-0107
Mailing address
1408 S SCHILLER ST, LITTLE ROCK, AR 72202-5817
(501) 507-0675
(501) 421-0107
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/11/2017
Last updated
11/30/2020
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