Provider Demographics
NPI:1689998080
Name:THE PARKER GROUP, INC.
Entity Type:Organization
Organization Name:THE PARKER GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:316-250-8436
Mailing Address - Street 1:112 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-2005
Mailing Address - Country:US
Mailing Address - Phone:316-250-8436
Mailing Address - Fax:316-260-9023
Practice Address - Street 1:112 E 2ND ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2005
Practice Address - Country:US
Practice Address - Phone:316-250-8436
Practice Address - Fax:316-260-9023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLP-1045103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100370650AMedicaid
KS100370650AMedicaid
KSS89682Medicare UPIN