Provider Demographics
NPI:1568594869
Name:BILLINS, JACLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:
Last Name:BILLINS
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 1:3212 S CRESENT DR
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-4209
Mailing Address - Country:US
Mailing Address - Phone:501-837-8952
Mailing Address - Fax:
Practice Address - Street 1:701 SOUTH ST STE 100
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-4452
Practice Address - Country:US
Practice Address - Phone:501-955-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3242-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical