Provider Demographics
NPI:1134093958
Name:PARKER, SAMUEL JOSEPH III (LICSW)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:JOSEPH
Last Name:PARKER
Suffix:III
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12243 FLETCHERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4523
Mailing Address - Country:US
Mailing Address - Phone:202-409-0984
Mailing Address - Fax:
Practice Address - Street 1:12243 FLETCHERTOWN RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4523
Practice Address - Country:US
Practice Address - Phone:202-409-0984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC50082824101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health