Provider Demographics
NPI:1134295900
Name:PARKER, DEANSIN GOODSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEANSIN
Middle Name:GOODSON
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0807
Mailing Address - Country:US
Mailing Address - Phone:212-988-0898
Mailing Address - Fax:
Practice Address - Street 1:1148 5TH AVE
Practice Address - Street 2:STE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0807
Practice Address - Country:US
Practice Address - Phone:212-988-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2008-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5094103G00000X, 103TC0700X, 103TC2200X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic