Healthcare Provider Details

I. General information

NPI: 1487368700
Provider Name (Legal Business Name): ADAYSHA PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADAYSHA KING

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 WAYNE RD
ROMULUS MI
48174-1551
US

IV. Provider business mailing address

26901 BEAUMONT BLVD STE 3D
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 734-942-4857
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851116050
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: