Provider Demographics
NPI:1861464885
Name:BANKHEAD, MARLA (LPC)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:BANKHEAD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARLA
Other - Middle Name:A
Other - Last Name:NEWKIRK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2110 HIGDON FERRY RD STE D
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-7288
Mailing Address - Country:US
Mailing Address - Phone:501-262-2766
Mailing Address - Fax:501-262-2544
Practice Address - Street 1:2110 HIGDON FERRY RD STE D
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-7288
Practice Address - Country:US
Practice Address - Phone:501-262-2766
Practice Address - Fax:501-262-2544
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0410040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y140OtherBLUE CROSS & BLUE SHIELD