Provider Demographics
NPI:1730331653
Name:WOMACK, KAREN J (LMSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:WOMACK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:AR
Mailing Address - Zip Code:72079-0363
Mailing Address - Country:US
Mailing Address - Phone:870-810-0498
Mailing Address - Fax:
Practice Address - Street 1:1900 PINE ST
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-2401
Practice Address - Country:US
Practice Address - Phone:501-771-8261
Practice Address - Fax:501-771-8263
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical