Provider Demographics
NPI:1508815309
Name:PARKS, KRISTINE R (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:R
Last Name:PARKS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:355 UNION ST
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740
Mailing Address - Country:US
Mailing Address - Phone:774-644-5920
Mailing Address - Fax:
Practice Address - Street 1:355 UNION ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740
Practice Address - Country:US
Practice Address - Phone:774-644-5920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health