Provider Demographics
NPI:1174551535
Name:KARBO, ANITA (LCSW)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:KARBO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:BARE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1100 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-1944
Mailing Address - Country:US
Mailing Address - Phone:479-521-5731
Mailing Address - Fax:479-521-6520
Practice Address - Street 1:1100 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-521-5731
Practice Address - Fax:479-521-6520
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1471-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR000278989OtherUBH
AR06070019200OtherQUALCHOICE
AR5X776OtherBLUE CROSS
AR06070019200OtherQUALCHOICE