Christopher Ray Rouse
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Gravette, AR
NPI 1164032702 · NPPES record last updated May 17, 2024
Key facts
- NPI
- 1164032702
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 2201 (AR)
- Practice address
- 210 White Oak Dr NE Apt a
Gravette, AR 72736-9629 - Phone
- (918) 353-2556
- NPI assigned
- Aug 7, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2201 | AR | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | 2201 | AR | Yes |
Addresses
Primary practice location
210 White Oak Dr NE Apt a
Gravette, AR 72736-9629
Mailing address
210 White Oak Dr NE Apt a
Gravette, AR 72736-9629
Phone (918) 353-2556
Other providers in Gravette, AR
- Stephen K Morrison
- Kenneth Marcus Poemoceah
- Karen I Privett
- Mylynda Privett
- Debbie Query
- Ty D Russell
- Kenneth Jake Sample
- Sgoh Acquisition Inc
- Sgoh Acquisition Inc
- Sgoh Acquisition Inc
All providers in Gravette, AR · Addiction (Substance Use Disorder) Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.