Healthcare Provider Details

I. General information

NPI: 1083262141
Provider Name (Legal Business Name): PARKER PRESTON LPC, QMHP, CADCIII
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROBERT C PRESTON JR. QMHP, CADCIII

II. Dates (important events)

Enumeration Date: 08/30/2019
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 SE HIGHWAY 101
LINCOLN CITY OR
97367-2773
US

IV. Provider business mailing address

820 SE HIGHWAY 101
LINCOLN CITY OR
97367-2773
US

V. Phone/Fax

Practice location:
  • Phone: 541-216-7131
  • Fax:
Mailing address:
  • Phone: 503-308-2252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number22-R-13
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC11481
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number22-QMHPC-001173
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: