Provider Demographics
NPI:1174956130
Name:PARKER, MEREDITH (LPC, LCPC)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 HASTINGS DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3389
Mailing Address - Country:US
Mailing Address - Phone:570-817-7136
Mailing Address - Fax:
Practice Address - Street 1:1711 HASTINGS DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3389
Practice Address - Country:US
Practice Address - Phone:570-817-7136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006996101YP2500X
IL180008937101YP2500X
TX80842101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180008937OtherIDFPR
PAPC006996OtherLICENSED PROFESSIONAL COUNSELOR
TX80842OtherTEXAS STATE BOARD OF EXAMINERS