Provider Demographics
NPI:1124178512
Name:PARKER, HUBERT WAYNE (MS, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:HUBERT
Middle Name:WAYNE
Last Name:PARKER
Suffix:
Gender:M
Credentials:MS, NCC, 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 117
Mailing Address - Street 2:
Mailing Address - City:PHEBA
Mailing Address - State:MS
Mailing Address - Zip Code:39755-0117
Mailing Address - Country:US
Mailing Address - Phone:662-386-7854
Mailing Address - Fax:
Practice Address - Street 1:322 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2955
Practice Address - Country:US
Practice Address - Phone:662-338-1880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional