Provider Demographics
NPI:1124280011
Name:PARKER, LAURA ELIZABETH (LPC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ELIZABETH
Last Name:PARKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RIVERSTONE MEDICAL CAMPUS
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513
Mailing Address - Country:US
Mailing Address - Phone:770-235-1059
Mailing Address - Fax:
Practice Address - Street 1:101 RIVERSTONE VIS
Practice Address - Street 2:SUITE 201 A
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6648
Practice Address - Country:US
Practice Address - Phone:770-235-1059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional