Provider Demographics
NPI:1639763279
Name:PARKER, JORDYN WOODS (LPC)
Entity Type:Individual
Prefix:
First Name:JORDYN
Middle Name:WOODS
Last Name:PARKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 MCCLANAHAN ST SW STE C
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1712
Mailing Address - Country:US
Mailing Address - Phone:540-390-0088
Mailing Address - Fax:
Practice Address - Street 1:306 MCCLANAHAN ST SW STE C
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1712
Practice Address - Country:US
Practice Address - Phone:540-390-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional