Healthcare Provider Details

I. General information

NPI: 1447176839
Provider Name (Legal Business Name): TAMARA PELKEY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S AVALON ST
WEST MEMPHIS AR
72301-4165
US

IV. Provider business mailing address

103 S AVALON ST
WEST MEMPHIS AR
72301-4165
US

V. Phone/Fax

Practice location:
  • Phone: 870-732-1878
  • Fax: 870-702-7111
Mailing address:
  • Phone: 870-732-1878
  • Fax: 870-702-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: