Provider Demographics
NPI:1669789509
Name:EUBANKS, MICHAEL E (LMSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:E
Last Name:EUBANKS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2213 N REYNOLDS RD STE 26
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-2581
Mailing Address - Country:US
Mailing Address - Phone:501-303-6108
Mailing Address - Fax:501-399-4043
Practice Address - Street 1:2213 N REYNOLDS RD STE 26
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-2581
Practice Address - Country:US
Practice Address - Phone:501-303-6108
Practice Address - Fax:501-399-4043
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7872-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker