Provider Demographics
NPI:1558588590
Name:LANCASTER, TAMEKA L (LCSW, LADAC)
Entity Type:Individual
Prefix:MISS
First Name:TAMEKA
Middle Name:L
Last Name:LANCASTER
Suffix:
Gender:F
Credentials:LCSW, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S SHACKLEFORD RD STE 30
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3817
Mailing Address - Country:US
Mailing Address - Phone:501-251-8330
Mailing Address - Fax:501-246-8484
Practice Address - Street 1:900 S SHACKLEFORD RD STE 30
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3817
Practice Address - Country:US
Practice Address - Phone:501-251-8330
Practice Address - Fax:501-246-8484
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1890-C1041C0700X
AR0239 L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR158863719Medicaid