Provider Demographics
NPI:1093722316
Name:PARKER, J HEIDI (LPC)
Entity Type:Individual
Prefix:
First Name:J
Middle Name:HEIDI
Last Name:PARKER
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:PO BOX 940165
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75094-0165
Mailing Address - Country:US
Mailing Address - Phone:214-282-1675
Mailing Address - Fax:
Practice Address - Street 1:1465 MUNICIPAL AVE
Practice Address - Street 2:STE 3119
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6293
Practice Address - Country:US
Practice Address - Phone:214-282-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19079101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX19079OtherSTATE LICENSE