Provider Demographics
NPI:1073022166
Name:MACKEY, JASMINE (LCSW)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:MACKEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6360
Mailing Address - Country:US
Mailing Address - Phone:501-686-9616
Mailing Address - Fax:
Practice Address - Street 1:6210 BASELINE RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-4728
Practice Address - Country:US
Practice Address - Phone:501-265-0302
Practice Address - Fax:501-265-0300
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker