Provider Demographics
NPI:1790724946
Name:PARKER, CHRISTIAN A (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:A
Last Name:PARKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRIST
Other - Middle Name:ANN
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3030 NORTH ST
Mailing Address - Street 2:SUITE 530
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1433
Mailing Address - Country:US
Mailing Address - Phone:800-230-7525
Mailing Address - Fax:866-404-5622
Practice Address - Street 1:650 S EDMONDS LN
Practice Address - Street 2:SUITE 106
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3511
Practice Address - Country:US
Practice Address - Phone:214-396-3960
Practice Address - Fax:214-396-3962
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0035381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical