Provider Demographics
NPI:1386037364
Name:CAROL L. PARKER PH.D.LPCC
Entity type:Organization
Organization Name:CAROL L. PARKER PH.D.LPCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LPCC
Authorized Official - Phone:505-235-1284
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:GLORIETA
Mailing Address - State:NM
Mailing Address - Zip Code:87535-0544
Mailing Address - Country:US
Mailing Address - Phone:505-235-1284
Mailing Address - Fax:505-982-9401
Practice Address - Street 1:1600 LENA ST STE C
Practice Address - Street 2:#30
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3891
Practice Address - Country:US
Practice Address - Phone:505-235-1284
Practice Address - Fax:505-982-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-14
Last Update Date:2015-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4775251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health