Provider Demographics
NPI:1275914301
Name:PARKER, JAIME LEE (MSW, LCSW, LCASA)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LEE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSW, LCSW, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12721 DARBY BROOK CT STE 102
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2408
Mailing Address - Country:US
Mailing Address - Phone:703-497-1771
Mailing Address - Fax:703-497-1225
Practice Address - Street 1:911 HAY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305
Practice Address - Country:US
Practice Address - Phone:910-438-0939
Practice Address - Fax:910-438-0942
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0112571041C0700X
NC234011041C0700X
VA09040105021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical