Provider Demographics
NPI:1528656535
Name:PARKER, ABBYGAIL KATHERINE
Entity type:Individual
Prefix:
First Name:ABBYGAIL
Middle Name:KATHERINE
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBI
Other - Middle Name:LYNN
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 N ALABAMA ST STE 350
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2152
Mailing Address - Country:US
Mailing Address - Phone:317-268-8438
Mailing Address - Fax:
Practice Address - Street 1:303 N ALABAMA ST STE 350
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2152
Practice Address - Country:US
Practice Address - Phone:317-268-8438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61570405106H00000X
390200000X
IN35002445A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN35002445AOtherLMFT LICENSE
WALF61570405OtherLMFT LICENSE