Healthcare Provider Details

I. General information

NPI: 1881673028
Provider Name (Legal Business Name): TAMI LYNN PARKE LPC LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5340 HOLIDAY TER
KALAMAZOO MI
49009-2196
US

IV. Provider business mailing address

5340 HOLIDAY TER
KALAMAZOO MI
49009-2196
US

V. Phone/Fax

Practice location:
  • Phone: 269-372-4140
  • Fax: 269-372-0390
Mailing address:
  • Phone: 269-372-4140
  • Fax: 269-372-0390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401006932
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6301010634
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: