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General NPI Number Information
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NPI Number | 1386037364
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Entity Type | Organization
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Legal Business Name | CAROL L. PARKER PH.D.LPCC
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Dates
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Enumeration Date | 03/14/2015
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Last Update Date | 03/14/2015
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Provider Practice Location Address
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Address Line | 1600 LENA ST STE C #30
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City | SANTA FE
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State | NM
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Zip | 87505-3891
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Country | US
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Telephone | 505-235-1284
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Fax | 505-982-9401
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Provider Business Mailing Address
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Address Line | PO BOX 544
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City | GLORIETA
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State | NM
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Zip | 87535-0544
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Country | US
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Telephone | 505-235-1284
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Fax | 505-982-9401
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. CAROL L. PARKER
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Credential | PH.D. LPCC
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Telephone | 505-235-1284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4775
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License Number State | NM
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