Provider Demographics
NPI:1750094702
Name:PARKER, SYDNEY (ACMHC, LAC, NCC, CRC)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:ACMHC, LAC, NCC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 E SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5347
Mailing Address - Country:US
Mailing Address - Phone:281-509-1122
Mailing Address - Fax:
Practice Address - Street 1:4500 E SUNRISE DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5347
Practice Address - Country:US
Practice Address - Phone:281-509-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-20229101YM0800X
UT9578295-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ20229OtherSTATE OF ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS
UT9578295-6009OtherSTATE OF UTAH DEPARTMENT OF COMMERCE