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General NPI Number Information
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NPI Number | 1073178992
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Entity Type | Individual
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Provider Name | MS. CHAMEKA KONSWELA PARKS
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Gender | Female
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 128 MILLPORT CIR STE 200
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City | GREENVILLE
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State | SC
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Zip | 29607-5573
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Country | US
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Telephone | 864-808-0218
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Fax | 864-568-7265
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Provider Business Mailing Address
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Address Line | 1521 LAURENS RD UNIT 7003
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City | GREENVILLE
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State | SC
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Zip | 29606-1075
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Country | US
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Telephone | 864-808-0218
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Fax | 864-568-7265
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7344
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License Number State | SC
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