Provider Demographics
NPI:1629226907
Name:PARKS, NATASHA ELEANOR (MSW)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:ELEANOR
Last Name:PARKS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 APRICOT CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2257
Mailing Address - Country:US
Mailing Address - Phone:301-390-2221
Mailing Address - Fax:
Practice Address - Street 1:2101 APRICOT CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2257
Practice Address - Country:US
Practice Address - Phone:301-390-2221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD030851041C0700X
DCLC3004681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical