Provider Demographics
NPI:1780006452
Name:PARKER, ERICKA M (BSW)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:M
Last Name:PARKER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 EDGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01904-1523
Mailing Address - Country:US
Mailing Address - Phone:339-440-1215
Mailing Address - Fax:
Practice Address - Street 1:51 EDGE HILL RD
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-1523
Practice Address - Country:US
Practice Address - Phone:339-440-1215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS73470515101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor