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General NPI Number Information
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NPI Number | 1114105194
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Entity Type | Individual
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Provider Name | CAITLIN A PARKER M.A., LCPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 2584 N STOKESBERRY PL
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City | MERIDIAN
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State | ID
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Zip | 83646-1144
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Country | US
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Telephone | 208-695-7517
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Fax | 208-288-5779
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Provider Business Mailing Address
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Address Line | 841 E FAIRVIEW AVE STE 100
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City | MERIDIAN
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State | ID
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Zip | 83642-9386
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Country | US
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Telephone | 208-695-7517
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Fax | 208-907-5229
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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 | LCPC-4492
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License Number State | ID
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