Provider Demographics
NPI:1215362470
Name:PARKS, DONNA ELAINE (BS, LCDC, CAMF)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:ELAINE
Last Name:PARKS
Suffix:
Gender:F
Credentials:BS, LCDC, CAMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S PALESTINE ST
Mailing Address - Street 2:P.O. BOX 2536
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-3325
Mailing Address - Country:US
Mailing Address - Phone:903-675-9570
Mailing Address - Fax:
Practice Address - Street 1:700 S PALESTINE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-3325
Practice Address - Country:US
Practice Address - Phone:903-675-9570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4648101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)