MEDICARE: CLAIRE SMITH PARKER

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	101YM0800X	Mental Health Counselor	MSW007514	GA

General Provider Information

NPI Number	:	1225687775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE SMITH PARKER

Provider Business Mailing Address
First Line	:	941 WHITE STAG LN
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-2246
Country	:	US
Telephone Number	:	404-405-5158
Fax Number	:

Provider Business Practice Location Address
First Line	:	11807 NORTHFALL LN STE 902
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30009-7972
Country	:	US
Telephone Number	:	770-240-1037
Fax Number	:

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

Provider Enumeration Date	:	09/07/2019
Last Update Date	:	09/07/2019

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Directions to “ CLAIRE SMITH PARKER ” Practice Location

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