Provider Demographics
NPI:1790082964
Name:DEERE, BETTY (LCSW)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:DEERE
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 1:10201 W MARKHAM ST STE 212
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2181
Mailing Address - Country:US
Mailing Address - Phone:501-615-5468
Mailing Address - Fax:
Practice Address - Street 1:10201 W MARKHAM ST STE 212
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2181
Practice Address - Country:US
Practice Address - Phone:501-615-5468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR820-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical