Provider Demographics
NPI:1992940464
Name:PARKER, JULIA ELIZABETH (LPC, MHSP)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ELIZABETH
Last Name:PARKER
Suffix:
Gender:F
Credentials:LPC, MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6810 CRUMPLER BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-1933
Mailing Address - Country:US
Mailing Address - Phone:901-497-6827
Mailing Address - Fax:662-890-0622
Practice Address - Street 1:6810 CRUMPLER BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-1933
Practice Address - Country:US
Practice Address - Phone:901-497-6827
Practice Address - Fax:662-890-0622
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2422101YP2500X
MS1439101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional