Organization Active NPI

Life Strategies Counseling, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Blytheville, AR
National Provider Identifier
1770956682
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
LIFE STRATEGIES COUNSELING, INC.
Practice address
514 Chickasawba St
Blytheville, AR 72315-2722
Phone
(870) 824-2268
Fax
(870) 824-2269
NPI assigned
Nov 2, 2015
Last updated
Dec 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Javier Malave
Title
Ceo
Phone
(904) 605-4986

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

514 Chickasawba St
Blytheville, AR 72315-2722

Mailing address

2200 E Matthews Ave
Jonesboro, AR 72401-4347
Phone (870) 972-1268

Other identifiers 1

IdentifierTypeStateIssuer
175598526MedicaidAR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1770956682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014347",
            "telephone_number": "870-972-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 CHICKASAWBA ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152722",
            "telephone_number": "870-824-2268",
            "fax_number": "870-824-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE STRATEGIES COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "MALAVE",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-605-4986"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175598526",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blytheville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.