Provider Demographics
NPI:1619115052
Name:MCMAHAN, BETSY (LPC)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:MCMAHAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:AR
Mailing Address - Zip Code:71929-0075
Mailing Address - Country:US
Mailing Address - Phone:870-245-6914
Mailing Address - Fax:501-332-4403
Practice Address - Street 1:205 N 26TH ST
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4336
Practice Address - Country:US
Practice Address - Phone:870-245-6915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1105030101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional