Provider Demographics
NPI:1366797474
Name:TAPP, SKY MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:SKY
Middle Name:MARIE
Last Name:TAPP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SKY
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:32 EMERALD CIR
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-8176
Mailing Address - Country:US
Mailing Address - Phone:501-259-4723
Mailing Address - Fax:833-520-1539
Practice Address - Street 1:2120 W MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-7442
Practice Address - Country:US
Practice Address - Phone:501-615-4028
Practice Address - Fax:833-520-1539
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6686-M104100000X
AR6686-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker