NPIMap

Organization Active NPI

Activelife Counseling, LLC

  • Professional Counselor
  • Fayetteville, AR
National Provider Identifier
1053918169
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
ACTIVELIFE COUNSELING, LLC
Practice address
2863 E Hyland Park Rd
Fayetteville, AR 72701-3818
Phone
(479) 601-6507
NPI assigned
Oct 2, 2020
Last updated
Feb 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rachel Wirth, LPCNPI 1104540483
Title
Clinician, Owner
Phone
(479) 601-6507

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

2863 E Hyland Park Rd
Fayetteville, AR 72701-3818

Mailing address

2863 E Hyland Park Rd
Fayetteville, AR 72701-3818
Phone (479) 601-6507

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1053918169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2863 E HYLAND PARK RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727013818",
            "telephone_number": "479-601-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 E HYLAND PARK RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727013818",
            "telephone_number": "479-601-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVELIFE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "WIRTH",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "CLINICIAN, OWNER",
        "authorized_official_telephone_number": "479-601-6507",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.