Healthcare Provider Details

I. General information

NPI: 1235428020
Provider Name (Legal Business Name): GISELE C.W. PARKER M.ED, NCC, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2011
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8258 VETERANS HWY STE 13
MILLERSVILLE MD
21108-1564
US

IV. Provider business mailing address

1511 RITCHIE HWY STE 202
ARNOLD MD
21012-2410
US

V. Phone/Fax

Practice location:
  • Phone: 410-768-6088
  • Fax:
Mailing address:
  • Phone: 410-757-2077
  • Fax: 410-757-5184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC3762
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC3762
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: