Provider Demographics
NPI:1922548056
Name:TANKS, EDAYSHIA (LPC)
Entity Type:Individual
Prefix:
First Name:EDAYSHIA
Middle Name:
Last Name:TANKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DAYSHIA
Other - Middle Name:
Other - Last Name:TANKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:1202 MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-5057
Mailing Address - Country:US
Mailing Address - Phone:501-238-1924
Mailing Address - Fax:
Practice Address - Street 1:1202 MAIN ST STE 202
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:501-238-1924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ARP1902024101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health