Provider Demographics
NPI:1063777381
Name:PARKS, CYNTHIA (CADC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:PARKS
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 BRIDGEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-1616
Mailing Address - Country:US
Mailing Address - Phone:302-629-2300
Mailing Address - Fax:302-629-2305
Practice Address - Street 1:1309 BRIDGEVILLE HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1616
Practice Address - Country:US
Practice Address - Phone:302-629-2300
Practice Address - Fax:302-629-2305
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1799101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)