Provider Demographics
NPI:1578359568
Name:BOCKELMAN COUNSELING LLC
Entity type:Organization
Organization Name:BOCKELMAN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOCKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-200-4248
Mailing Address - Street 1:6405 S 37TH ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1619
Mailing Address - Country:US
Mailing Address - Phone:479-200-4248
Mailing Address - Fax:
Practice Address - Street 1:808 S WALTON BLVD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6235
Practice Address - Country:US
Practice Address - Phone:479-200-4248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty