Organization Name: | FAMILY PSYCHOLOGICAL CENTER |
NPI Number: | 1033293733 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM CHARLES NICHOLS (DIRECTOR/CEO) |
Mailing Address: | 623 N Walnut St Harrison |
State: | AR US |
Postal Code: | 726013617 |
Phone Number: | 8707436225 |
Fax Number: | 8707436006 |
NPI Enumeration Date: | 10/25/2006 |
NPI Last Update Date: | 01/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 00-12P |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |