Provider Demographics
NPI:1760074983
Name:PARKS, MAKENZIE (LCSW)
Entity Type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:
Last Name:PARKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 FAIRMONT CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1051
Mailing Address - Country:US
Mailing Address - Phone:615-474-9141
Mailing Address - Fax:
Practice Address - Street 1:232 FAIRMONT CT
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1051
Practice Address - Country:US
Practice Address - Phone:615-474-9141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN72791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical