Provider Demographics
NPI:1316006935
Name:IKERD, HEALEY EUNICE (LPC/LAMFT)
Entity Type:Individual
Prefix:MRS
First Name:HEALEY
Middle Name:EUNICE
Last Name:IKERD
Suffix:
Gender:F
Credentials:LPC/LAMFT
Other - Prefix:MISS
Other - First Name:HEALEY
Other - Middle Name:EUNICE
Other - Last Name:TONSING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 11051
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-1001
Mailing Address - Country:US
Mailing Address - Phone:479-409-8256
Mailing Address - Fax:479-751-0885
Practice Address - Street 1:4210 N FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5001
Practice Address - Country:US
Practice Address - Phone:479-409-8256
Practice Address - Fax:479-751-0885
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA0802008101Y00000X
101YP2500X, 171M00000X
ARP1108054101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator