Provider Demographics
NPI:1396864161
Name:PARKER, CATHY HICKINGBOTTOM (LMFT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:HICKINGBOTTOM
Last Name:PARKER
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:103 DAVENPORT AVENUE
Mailing Address - City:MER ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:71261-0445
Mailing Address - Country:US
Mailing Address - Phone:318-647-5030
Mailing Address - Fax:318-647-5040
Practice Address - Street 1:103 DAVENPORT AVE.
Practice Address - Street 2:
Practice Address - City:MER ROUGE
Practice Address - State:LA
Practice Address - Zip Code:71261-0445
Practice Address - Country:US
Practice Address - Phone:318-647-5030
Practice Address - Fax:318-647-5040
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3065101YM0800X
LA992106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist