MEDICARE: MACQUEEN PARKER LCSW-C

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	1041C0700X	Clinical Social Worker	09683	MD

General Provider Information

NPI Number	:	1376291781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACQUEEN PARKER LCSW-C

Provider Business Mailing Address
First Line	:	637 WELLER DR
Second Line	:
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-3440
Country	:	US
Telephone Number	:	410-627-8039
Fax Number	:

Provider Business Practice Location Address
First Line	:	3290 N RIDGE RD STE 320
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-3668
Country	:	US
Telephone Number	:	410-461-3760
Fax Number	:

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

Provider Enumeration Date	:	03/15/2022
Last Update Date	:	03/15/2022

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Directions to “ MACQUEEN PARKER LCSW-C” Practice Location

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