MEDICARE: MR. JERE FRANCIS PARKER L.C.S.W.

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	87000092A	IN
2	1041C0700X	Clinical Social Worker	3400-2520A	IN

General Provider Information

NPI Number	:	1205148855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JERE FRANCIS PARKER L.C.S.W.

Provider Business Mailing Address
First Line	:	3250 MANNING RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46228-2862
Country	:	US
Telephone Number	:	317-297-7543
Fax Number	:	317-297-6539

Provider Business Practice Location Address
First Line	:	2511 E 46TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-2460
Country	:	US
Telephone Number	:	317-590-4498
Fax Number	:	317-297-6539

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2010
Last Update Date	:	03/22/2026

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