Provider Demographics
NPI:1760143697
Name:PARKER, VIRGINIA JOANNE (LICSW)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:JOANNE
Last Name:PARKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 N ELLA RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2094
Mailing Address - Country:US
Mailing Address - Phone:509-879-1067
Mailing Address - Fax:
Practice Address - Street 1:608 E HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1255
Practice Address - Country:US
Practice Address - Phone:509-489-4581
Practice Address - Fax:509-482-0717
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW607087951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical