Provider Demographics
NPI:1306183272
Name:PARKER, KIMBERLY ROCHELLE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ROCHELLE
Last Name:PARKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:MANNING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:2724 OPAL CV
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-2381
Mailing Address - Country:US
Mailing Address - Phone:501-606-4711
Mailing Address - Fax:501-257-1421
Practice Address - Street 1:2200 FORT ROOTS DR RM 111
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1709
Practice Address - Country:US
Practice Address - Phone:501-257-1484
Practice Address - Fax:501-257-1421
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor