MEDICARE: JENNIFER EILEEN PARKER MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	34001832A	IN

General Provider Information

NPI Number	:	1023662442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER EILEEN PARKER MSW, LCSW

Provider Business Mailing Address
First Line	:	7789 MALLARD LNDG
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-9516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4582 NW PLAZA WEST DR STE 9
Second Line	:
City	:	ZIONSVILLE
State	:	IN
Zip	:	46077-9270
Country	:	US
Telephone Number	:	317-627-6893
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2019
Last Update Date	:	07/25/2019

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