Provider Demographics
NPI:1275191488
Name:PARKES, THOMAS RAYMOND (LCSWA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:RAYMOND
Last Name:PARKES
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BARCLAY RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-1404
Mailing Address - Country:US
Mailing Address - Phone:860-877-9277
Mailing Address - Fax:
Practice Address - Street 1:288 EAST ST STE F72001
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-9711
Practice Address - Country:US
Practice Address - Phone:919-704-8449
Practice Address - Fax:919-704-8617
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0134661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical