Provider Demographics
NPI:1730584491
Name:PARKER, VICKIE LYNN (LMFTA)
Entity type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:LYNN
Last Name:PARKER
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4363 LYNBROOK LOOP APT 2
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-6850
Mailing Address - Country:US
Mailing Address - Phone:530-710-3878
Mailing Address - Fax:530-223-4820
Practice Address - Street 1:1930 WEST ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1765
Practice Address - Country:US
Practice Address - Phone:530-710-3878
Practice Address - Fax:530-242-6296
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 52097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health