Provider Demographics
NPI:1306385216
Name:PARKS, MEAGAN (MS, LPC, RPT)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:PARKS
Suffix:
Gender:F
Credentials:MS, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 N CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3008
Mailing Address - Country:US
Mailing Address - Phone:214-530-9034
Mailing Address - Fax:
Practice Address - Street 1:2520 N CARROLL AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3008
Practice Address - Country:US
Practice Address - Phone:214-530-9034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health