Provider Demographics
NPI:1427036037
Name:PARKE, AMY L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:L
Last Name:PARKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6047 COUNTY ROAD 223
Mailing Address - Street 2:
Mailing Address - City:KEMPNER
Mailing Address - State:TX
Mailing Address - Zip Code:76539-3753
Mailing Address - Country:US
Mailing Address - Phone:254-833-8889
Mailing Address - Fax:
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:DEPT OF EMERGENCY MEDICINE
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76554-4752
Practice Address - Country:US
Practice Address - Phone:254-288-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical