Provider Demographics
NPI:1093745283
Name:PARKER, LISA G (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:G
Last Name:PARKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BAYOU DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-3122
Mailing Address - Country:US
Mailing Address - Phone:401-524-4677
Mailing Address - Fax:
Practice Address - Street 1:33 COLLEGE HILL RD STE 30E
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2767
Practice Address - Country:US
Practice Address - Phone:401-821-6070
Practice Address - Fax:401-821-6047
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2022-06-28
Deactivation Date:2018-10-31
Deactivation Code:
Reactivation Date:2021-03-10
Provider Licenses
StateLicense IDTaxonomies
RIISW0009851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical