Healthcare Provider Details

I. General information

NPI: 1821468794
Provider Name (Legal Business Name): MASHONE PARKER-WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2015
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 FOUNTAIN DR
CROWN POINT IN
46307-5324
US

IV. Provider business mailing address

5201 FOUNTAIN DR
CROWN POINT IN
46307-5324
US

V. Phone/Fax

Practice location:
  • Phone: 219-472-8277
  • Fax: 219-321-9300
Mailing address:
  • Phone: 815-402-1555
  • Fax: 219-321-9300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180016781
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number180016781
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: