Healthcare Provider Details

I. General information

NPI: 1538082714
Provider Name (Legal Business Name): MICHAELYNN JOYCE PARKS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 LOUIE ST
LAKE CHARLES LA
70601-7250
US

IV. Provider business mailing address

220 LOUIE ST
LAKE CHARLES LA
70601-7250
US

V. Phone/Fax

Practice location:
  • Phone: 337-436-9533
  • Fax:
Mailing address:
  • Phone: 337-436-9533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14713
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: