Provider Demographics
NPI:1578033288
Name:PARKER, DARRELL LOUIS (LCPC)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:LOUIS
Last Name:PARKER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 KETTERING DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1552
Mailing Address - Country:US
Mailing Address - Phone:240-988-9681
Mailing Address - Fax:
Practice Address - Street 1:422 KETTERING DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1552
Practice Address - Country:US
Practice Address - Phone:301-357-4628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC12606101Y00000X, 101YP2500X, 101YM0800X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty