Provider Demographics
NPI:1366552192
Name:PARKS, CINDY LOU (LPC)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:LOU
Last Name:PARKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 N SQUIRREL RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2846
Mailing Address - Country:US
Mailing Address - Phone:248-800-6931
Mailing Address - Fax:248-605-3525
Practice Address - Street 1:39425 GARFIELD RD STE 23
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-4651
Practice Address - Country:US
Practice Address - Phone:800-693-1916
Practice Address - Fax:248-605-3525
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009105101Y00000X
MI6301012810103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling