Provider Demographics
NPI:1063592855
Name:PARKER, DANA JOLENE (LCSW, LMFT)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:JOLENE
Last Name:PARKER
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:MISS
Other - First Name:DANA
Other - Middle Name:JOLENE
Other - Last Name:FULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LMFT
Mailing Address - Street 1:202 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-3429
Mailing Address - Country:US
Mailing Address - Phone:812-941-0922
Mailing Address - Fax:812-941-0990
Practice Address - Street 1:200 S JOHN F KENNEDY AVE
Practice Address - Street 2:
Practice Address - City:LOOGOOTEE
Practice Address - State:IN
Practice Address - Zip Code:47553-1624
Practice Address - Country:US
Practice Address - Phone:812-295-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35000284A106H00000X
IN34003185A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist