Provider Demographics
NPI:1710184866
Name:PILCHER, MARITA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARITA
Middle Name:
Last Name:PILCHER
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 1:10810 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4354
Mailing Address - Country:US
Mailing Address - Phone:501-312-7578
Mailing Address - Fax:501-312-7577
Practice Address - Street 1:10810 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 303
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4354
Practice Address - Country:US
Practice Address - Phone:501-312-7578
Practice Address - Fax:501-312-7577
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR815-C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C823Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER