Provider Demographics
NPI:1467567859
Name:PARKER, KIM LY (LCSW)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:LY
Last Name:PARKER
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 1:4008 LOUETTA RD
Mailing Address - Street 2:# 338
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4405
Mailing Address - Country:US
Mailing Address - Phone:713-730-2335
Mailing Address - Fax:713-802-7676
Practice Address - Street 1:7026 BELGOLD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-1002
Practice Address - Country:US
Practice Address - Phone:713-291-2272
Practice Address - Fax:832-348-2751
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX346641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical