Provider Demographics
NPI:1497121396
Name:PARKER, JENNIFER LYNN (MLADC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:PARKER
Suffix:
Gender:F
Credentials:MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 BEACON ST W STE 3
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-3460
Mailing Address - Country:US
Mailing Address - Phone:603-524-4664
Mailing Address - Fax:603-524-4986
Practice Address - Street 1:61 BEACON ST W STE 3
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3460
Practice Address - Country:US
Practice Address - Phone:603-524-4664
Practice Address - Fax:603-524-4986
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH861101YA0400X
NH1234101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)