Healthcare Provider Details

I. General information

NPI: 1700015351
Provider Name (Legal Business Name): DAVID G. PARKER LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2009
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 HEALTH LN
WARWICK RI
02886-2711
US

IV. Provider business mailing address

6 BALDWIN RD
WARWICK RI
02886-2723
US

V. Phone/Fax

Practice location:
  • Phone: 401-732-5656
  • Fax: 401-738-8634
Mailing address:
  • Phone: 401-331-1350
  • Fax: 401-277-3366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW01921
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: