MEDICARE: CARRIE MICHELLE 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	LPC016387	GA

General Provider Information

NPI Number	:	1356294672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE MICHELLE PARKER

Provider Business Mailing Address
First Line	:	319 WATER OAK LN
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30114-4484
Country	:	US
Telephone Number	:	678-852-4449
Fax Number	:

Provider Business Practice Location Address
First Line	:	3459 ACWORTH DUE WEST RD NW
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-5819
Country	:	US
Telephone Number	:	678-587-8858
Fax Number	:

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

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “ CARRIE MICHELLE PARKER ” Practice Location

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