Provider Demographics
NPI:1235798158
Name:PARKER, JANELLE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 HOLLYDAY ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3230
Mailing Address - Country:US
Mailing Address - Phone:443-225-9579
Mailing Address - Fax:
Practice Address - Street 1:204 CEDAR ST STE 102
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2395
Practice Address - Country:US
Practice Address - Phone:443-351-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD200201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical