MEDICARE: PARKER PROFESSIONAL SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1184131336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKER PROFESSIONAL SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 870
Second Line	:
City	:	GEORGETOWN
State	:	KY
Zip	:	40324-0870
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 EUCLID AVE STE 203
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-6429
Country	:	US
Telephone Number	:	859-705-8075
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TRENT PARKER
Credential	:
Telephone Number	:	859-705-8075

Provider Enumeration Date	:	01/09/2018
Last Update Date	:	03/17/2026

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