Provider Demographics
NPI:1710546379
Name:DAVIS, LAKERA (LPC)
Entity Type:Individual
Prefix:
First Name:LAKERA
Middle Name:
Last Name:DAVIS
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 1:10201 W MARKHAM ST STE 348
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2195
Mailing Address - Country:US
Mailing Address - Phone:501-773-9330
Mailing Address - Fax:501-207-8640
Practice Address - Street 1:10201 W MARKHAM ST STE 348
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2195
Practice Address - Country:US
Practice Address - Phone:501-773-9330
Practice Address - Fax:501-207-8640
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1904045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional