Provider Demographics
NPI:1548789928
Name:PARKS, GREGORY A
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:A
Last Name:PARKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W MAIN, CIRCLEVILLE, OH 43113
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9367
Mailing Address - Country:US
Mailing Address - Phone:740-703-1350
Mailing Address - Fax:
Practice Address - Street 1:220 NORTH PLAZA BLVD, CHILLICOTHE, OHIO 45601
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3202
Practice Address - Country:US
Practice Address - Phone:740-703-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-16
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)