Provider Demographics
NPI:1225687775
Name:PARKER, CLAIRE SMITH
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:SMITH
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 WHITE STAG LN
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-2246
Mailing Address - Country:US
Mailing Address - Phone:404-405-5158
Mailing Address - Fax:
Practice Address - Street 1:11807 NORTHFALL LN STE 902
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7972
Practice Address - Country:US
Practice Address - Phone:770-240-1037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-07
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW007514101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health