Provider Demographics
NPI:1275191488
Name:PARKES, THOMAS RAYMOND (LCSW)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:RAYMOND
Last Name:PARKES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 PINE ACRES DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-2135
Mailing Address - Country:US
Mailing Address - Phone:860-877-9277
Mailing Address - Fax:
Practice Address - Street 1:20 E MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3848
Practice Address - Country:US
Practice Address - Phone:860-877-9277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0134661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical