Provider Demographics
NPI:1962620872
Name:PARKS, HENRY C (MA, LCAS, CCS)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:C
Last Name:PARKS
Suffix:
Gender:
Credentials:MA, LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-1838
Mailing Address - Country:US
Mailing Address - Phone:919-601-7719
Mailing Address - Fax:
Practice Address - Street 1:237 OAKDALE AVE
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-1838
Practice Address - Country:US
Practice Address - Phone:919-601-7719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1116101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)