Provider Demographics
NPI:1528535135
Name:PARKER, STEVEN JAMES (LCSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:PARKER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:STEVEN
Other - Middle Name:JAMES
Other - Last Name:MAILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1687 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4753
Mailing Address - Country:US
Mailing Address - Phone:203-522-0581
Mailing Address - Fax:
Practice Address - Street 1:1635 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2717
Practice Address - Country:US
Practice Address - Phone:203-551-7045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0102451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical