Provider Demographics
NPI:1639058217
Name:KERI L TIMMONS MS LPC NCC LICENSED PROFESSIONAL COUNSELING
Entity type:Organization
Organization Name:KERI L TIMMONS MS LPC NCC LICENSED PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PROFESSIOAL COUNSELO
Authorized Official - Prefix:MS
Authorized Official - First Name:KERI
Authorized Official - Middle Name:L
Authorized Official - Last Name:TIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, NCC
Authorized Official - Phone:479-925-0164
Mailing Address - Street 1:1500 CHITWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PEA RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72751-2766
Mailing Address - Country:US
Mailing Address - Phone:479-925-0164
Mailing Address - Fax:479-385-7050
Practice Address - Street 1:221 LEE TOWN RD
Practice Address - Street 2:
Practice Address - City:PEA RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72751-3203
Practice Address - Country:US
Practice Address - Phone:479-925-0164
Practice Address - Fax:479-385-7050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty