MEDICARE: STEPHANIE RAE 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1316806763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE RAE PARKER

Provider Business Mailing Address
First Line	:	9911 WHITE OAK RD
Second Line	:
City	:	WISE
State	:	VA
Zip	:	24293-4507
Country	:	US
Telephone Number	:	276-298-5034
Fax Number	:	276-213-3014

Provider Business Practice Location Address
First Line	:	155 VALLEY ST NE
Second Line	:
City	:	ABINGDON
State	:	VA
Zip	:	24210-2832
Country	:	US
Telephone Number	:	276-298-5034
Fax Number	:	276-213-3014

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

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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Directions to “ STEPHANIE RAE PARKER ” Practice Location

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