Healthcare Provider Details

I. General information

NPI: 1962811844
Provider Name (Legal Business Name): MARGARET PARKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7413 136TH LANE
CEDAR LAKE IN
46303-9192
US

IV. Provider business mailing address

7413 W 136TH LN
CEDAR LAKE IN
46303-9192
US

V. Phone/Fax

Practice location:
  • Phone: 219-677-4139
  • Fax:
Mailing address:
  • Phone: 219-677-4139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34006537A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.016574
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: