NPIMap

Organization Active NPI

Rehabilitation & Counseling Consultants

Doing business as Restored Life Counseling

  • Professional Counselor
  • Conway, AR
National Provider Identifier
1194076737
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P1101006 Issued in AR
Legal business name
REHABILITATION & COUNSELING CONSULTANTS
Doing business as
Restored Life Counseling
Practice address
930 Wingate St Ste D2
Conway, AR 72034-4837
Phone
(501) 499-8699
Fax
(501) 205-4588
NPI assigned
Sep 23, 2012
Last updated
Nov 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Dr. Tresvil Gerard Pack, PH.D., CRC, LPCNPI 1831494905
Title
President/Ceo
Phone
(501) 499-8699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X P1101006 AR Primary

Addresses

Primary practice location

930 Wingate St Ste D2
Conway, AR 72034-4837

Mailing address

PO Box 11770
Conway, AR 72034-0031
Phone (501) 499-8699

Other names 1

  • Restored Life Counseling Doing business as

National Provider Directory

National Provider Directory

Locations

710 S Country Club Rd
Conway, AR 72034
Phone (501) 499-8699

Practitioners & affiliated clinicians

Practitioners 7

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": "1348358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1194076737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11770",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720340031",
            "telephone_number": "501-499-8699",
            "fax_number": "501-205-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 WINGATE ST STE D2",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344837",
            "telephone_number": "501-499-8699",
            "fax_number": "501-205-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION & COUNSELING CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-23",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "TRESVIL",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "501-499-8699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., CRC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1101006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restored Life Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.