MEDICARE: ADAM FRED PARKER

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	1041C0700X	Clinical Social Worker	104598	TX
2	1041C0700X	Clinical Social Worker	11722-C	NV

General Provider Information

NPI Number	:	1871974352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM FRED PARKER

Provider Business Mailing Address
First Line	:	5080 TRANQUIL VIEW ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1889
Country	:	US
Telephone Number	:	253-389-3674
Fax Number	:

Provider Business Practice Location Address
First Line	:	5080 TRANQUIL VIEW ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1889
Country	:	US
Telephone Number	:	253-389-3674
Fax Number	:

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

Provider Enumeration Date	:	06/10/2015
Last Update Date	:	04/27/2026

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Directions to “ ADAM FRED PARKER ” Practice Location

Language	Start Address	Practice Location

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