Provider Demographics
NPI:1457549644
Name:PARKER, HEATHER M (LCSW)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:M
Last Name:PARKER
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:ROSENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3815 RIVER CROSSING PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-7766
Mailing Address - Country:US
Mailing Address - Phone:904-469-0117
Mailing Address - Fax:
Practice Address - Street 1:4651 SALISBURY RD STE 400
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6187
Practice Address - Country:US
Practice Address - Phone:904-469-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006330A1041C0700X
FLSW225411041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty