MEDICARE: MRS. JORDYN PARKER MT-BC, R-MFT

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	106H00000X	Marriage & Family Therapist	0730000734	VA
2	225A00000X	Music Therapist

General Provider Information

NPI Number	:	1427537968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JORDYN PARKER MT-BC, R-MFT

Provider Business Mailing Address
First Line	:	4155 CHAIN BRIDGE RD
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-4102
Country	:	US
Telephone Number	:	703-672-1474
Fax Number	:

Provider Business Practice Location Address
First Line	:	4155 CHAIN BRIDGE RD
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-4102
Country	:	US
Telephone Number	:	703-672-1474
Fax Number	:

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

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	02/02/2026

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