Provider Demographics
NPI:1326387507
Name:PARKER, NIKI DM (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:NIKI
Middle Name:DM
Last Name:PARKER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:MS
Other - First Name:NIKI
Other - Middle Name:DM
Other - Last Name:BARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:2770 CENTENNIAL RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1829
Mailing Address - Country:US
Mailing Address - Phone:419-794-0567
Mailing Address - Fax:419-794-0569
Practice Address - Street 1:331 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-1836
Practice Address - Country:US
Practice Address - Phone:567-402-0292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OHI12005591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker