Provider Demographics
NPI:1568139988
Name:PARKER, ELLIOT (LMSW)
Entity Type:Individual
Prefix:
First Name:ELLIOT
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CADMAN PLZ W FL PLAZA17
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3229
Mailing Address - Country:US
Mailing Address - Phone:844-434-2778
Mailing Address - Fax:
Practice Address - Street 1:300 CADMAN PLZ W FL PLAZA17
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3229
Practice Address - Country:US
Practice Address - Phone:844-434-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY107866-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker