Healthcare Provider Details

I. General information

NPI: 1144481284
Provider Name (Legal Business Name): ANDREA PARKS LMFT, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BROADWAY ST
DELHI LA
71232-3001
US

IV. Provider business mailing address

501 BROADWAY ST
DELHI LA
71232-3001
US

V. Phone/Fax

Practice location:
  • Phone: 318-878-5686
  • Fax: 318-878-6321
Mailing address:
  • Phone: 318-878-8656
  • Fax: 318-878-6321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3070
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1024
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: