Provider Demographics
NPI:1043951213
Name:BEAUTIFUL PATH COUNSELING LLC
Entity type:Organization
Organization Name:BEAUTIFUL PATH COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:DWAYNE
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:501-889-4880
Mailing Address - Street 1:37 WILLIAMSBURG LN
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72126-8686
Mailing Address - Country:US
Mailing Address - Phone:501-889-4880
Mailing Address - Fax:479-777-9928
Practice Address - Street 1:1305 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-5322
Practice Address - Country:US
Practice Address - Phone:501-500-1545
Practice Address - Fax:479-777-9928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-04
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty