MEDICARE: ALAINA PARKS MSW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1447014212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAINA PARKS MSW

Provider Business Mailing Address
First Line	:	8530 TOWNSHIP LINE RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-1927
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1909 N COLORADO AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-4530
Country	:	US
Telephone Number	:	317-748-4345
Fax Number	:

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

Provider Enumeration Date	:	02/12/2024
Last Update Date	:	02/12/2024

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