Provider Demographics
NPI:1508003724
Name:PARKER, PATRICIA PERRY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:PERRY
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 1:803 E MORENO ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-5266
Mailing Address - Country:US
Mailing Address - Phone:850-435-9696
Mailing Address - Fax:
Practice Address - Street 1:1403 W SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1242
Practice Address - Country:US
Practice Address - Phone:850-595-6913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW53921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical