Provider Demographics
NPI:1447933569
Name:CHARLOTTE FEATHERSTON COUNSELING AGENCY, LLC
Entity type:Organization
Organization Name:CHARLOTTE FEATHERSTON COUNSELING AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FEATHERSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-907-0848
Mailing Address - Street 1:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:MAMMOTH SPRING
Mailing Address - State:AR
Mailing Address - Zip Code:72554-1142
Mailing Address - Country:US
Mailing Address - Phone:870-907-0848
Mailing Address - Fax:417-322-6099
Practice Address - Street 1:275 MAIN ST
Practice Address - Street 2:
Practice Address - City:MAMMOTH SPRING
Practice Address - State:AR
Practice Address - Zip Code:72554-7484
Practice Address - Country:US
Practice Address - Phone:870-907-0848
Practice Address - Fax:417-322-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty