Provider Demographics
NPI:1093875452
Name:ALONZO C PARKER PC
Entity Type:Organization
Organization Name:ALONZO C PARKER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALONZO
Authorized Official - Middle Name:CARLTON
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:III
Authorized Official - Credentials:LPCMHSP
Authorized Official - Phone:615-453-3911
Mailing Address - Street 1:706 CADET CT
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2649
Mailing Address - Country:US
Mailing Address - Phone:615-453-3911
Mailing Address - Fax:615-449-4709
Practice Address - Street 1:706 CADET CT
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2649
Practice Address - Country:US
Practice Address - Phone:615-453-3911
Practice Address - Fax:615-449-4709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty