Healthcare Provider Details

I. General information

NPI: 1336559699
Provider Name (Legal Business Name): JAVANA LATRICE BANKS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAVANA LATRICE WILLIAMS LPC

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 PLEASANT GROVE RD
JONESBORO AR
72405-7870
US

IV. Provider business mailing address

250 SMOKEY LN
NORTH LITTLE ROCK AR
72117-2506
US

V. Phone/Fax

Practice location:
  • Phone: 870-933-6886
  • Fax: 870-336-1339
Mailing address:
  • Phone: 870-933-6886
  • Fax: 870-336-1339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA2005069
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP2208008
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: