Provider Demographics
NPI:1659761583
Name:TAMEKA LANCASTER, LCSW, LADAC, LLC
Entity Type:Organization
Organization Name:TAMEKA LANCASTER, LCSW, LADAC, LLC
Other - Org Name:MIND FITNESS MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-251-8330
Mailing Address - Street 1:650 S SHACKLEFORD RD
Mailing Address - Street 2:SUITE 400-MM
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3522
Mailing Address - Country:US
Mailing Address - Phone:501-251-8330
Mailing Address - Fax:501-246-8484
Practice Address - Street 1:650 S SHACKLEFORD RD
Practice Address - Street 2:SUITE 400-MM
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3522
Practice Address - Country:US
Practice Address - Phone:501-251-8330
Practice Address - Fax:501-246-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health