Provider Demographics
NPI:1245424449
Name:PARKER, JOANNA MARIE (MA, LPC, CT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:MARIE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MA, LPC, CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7723 JOHNSON MILL RD
Mailing Address - Street 2:
Mailing Address - City:BAHAMA
Mailing Address - State:NC
Mailing Address - Zip Code:27503-8935
Mailing Address - Country:US
Mailing Address - Phone:919-479-3144
Mailing Address - Fax:
Practice Address - Street 1:BOX 3137 DUMC
Practice Address - Street 2:BEREAVEMENT SERVICES PROGRAM
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2678282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital