Provider Demographics
NPI:1760031835
Name:MARLER-RUSH, KAY C'ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:C'ANN
Last Name:MARLER-RUSH
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 1:1511 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-4933
Mailing Address - Country:US
Mailing Address - Phone:501-372-6297
Mailing Address - Fax:
Practice Address - Street 1:1202 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-5057
Practice Address - Country:US
Practice Address - Phone:501-372-6297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2274-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical