Healthcare Provider Details

I. General information

NPI: 1790576098
Provider Name (Legal Business Name): CAROLYN PARKER COUNSELING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5731 BLACK WALNUT POINT RD
TILGHMAN ISLAND MD
21671
US

IV. Provider business mailing address

26604 E BONFIELD RD
OXFORD MD
21654-1425
US

V. Phone/Fax

Practice location:
  • Phone: 303-845-0248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: CAROLYN BUTTON PARKER
Title or Position: OWNER
Credential:
Phone: 303-845-0248