Provider Demographics
NPI:1669881272
Name:PARKER PSYCHIATRIC SERVICES, INCORPORATED
Entity type:Organization
Organization Name:PARKER PSYCHIATRIC SERVICES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:HARRY
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:410-440-0317
Mailing Address - Street 1:940 MADISON AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2113
Mailing Address - Country:US
Mailing Address - Phone:410-440-0317
Mailing Address - Fax:
Practice Address - Street 1:940 MADISON AVE STE 202
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2113
Practice Address - Country:US
Practice Address - Phone:410-777-8710
Practice Address - Fax:443-434-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMH - 1474305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization