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General NPI Number Information
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NPI Number | 1851833297
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Entity Type | Individual
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Provider Name | MICHELLE C PARKER LISW-CP
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Gender | Female
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Dates
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Enumeration Date | 11/16/2016
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 1415 HIGHWAY 17 S
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-3803
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Country | US
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Telephone | 843-450-8182
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Fax |
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Provider Business Mailing Address
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Address Line | 900 WATERMARK CT
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-2574
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Country | US
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Telephone | 206-305-7455
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW60576422
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 15910
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License Number State | SC
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