Provider Demographics
NPI:1629526314
Name:BARKLEY, MARY AMANDA (LMSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:AMANDA
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4645
Mailing Address - Country:US
Mailing Address - Phone:870-926-6603
Mailing Address - Fax:
Practice Address - Street 1:1218 STONE ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4528
Practice Address - Country:US
Practice Address - Phone:870-972-1268
Practice Address - Fax:870-934-0847
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8013-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker