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General NPI Number Information
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NPI Number | 1417897190
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Entity Type | Individual
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Provider Name | MARY PARKS BA, CAP, NCPRSS
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Gender | Female
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 900 N CONGRESS AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3303
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Country | US
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Telephone | 561-223-6484
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Fax | 561-327-6484
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Provider Business Mailing Address
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Address Line | 8958 GREY EAGLE DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-1245
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Country | US
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Telephone | 561-596-2934
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | FL
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