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General NPI Number Information
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NPI Number | 1366797474
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Entity Type | Individual
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Provider Name | SKY MARIE TAPP LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 2120 W MAIN ST STE 5
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City | CABOT
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State | AR
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Zip | 72023-7442
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Country | US
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Telephone | 501-615-4028
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Fax | 833-520-1539
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Provider Business Mailing Address
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Address Line | 32 EMERALD CIR
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City | CABOT
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State | AR
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Zip | 72023-8176
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Country | US
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Telephone | 501-259-4723
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Fax | 833-520-1539
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6686-M
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6686-C
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License Number State | AR
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