MEDICARE: PARKER PRESTON LPC, QMHP, CADCIII

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	101YM0800X	Mental Health Counselor	C11481	OR
2	101YM0800X	Mental Health Counselor	22-QMHPC-001173	OR
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	22-R-13	OR

General Provider Information

NPI Number	:	1083262141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARKER PRESTON LPC, QMHP, CADCIII

Provider Business Mailing Address
First Line	:	820 SE HIGHWAY 101
Second Line	:
City	:	LINCOLN CITY
State	:	OR
Zip	:	97367-2773
Country	:	US
Telephone Number	:	503-308-2252
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 SE HIGHWAY 101
Second Line	:
City	:	LINCOLN CITY
State	:	OR
Zip	:	97367-2773
Country	:	US
Telephone Number	:	541-216-7131
Fax Number	:

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

Provider Enumeration Date	:	08/30/2019
Last Update Date	:	03/19/2026

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