Provider Demographics
NPI:1407110406
Name:PARKER, THOMAS ADAMS (LPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ADAMS
Last Name:PARKER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 DARIN DR
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:GA
Mailing Address - Zip Code:31008-3930
Mailing Address - Country:US
Mailing Address - Phone:478-919-8244
Mailing Address - Fax:
Practice Address - Street 1:116 DARIN DR
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:GA
Practice Address - Zip Code:31008-3930
Practice Address - Country:US
Practice Address - Phone:478-919-8244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional