Provider Demographics
NPI:1801011168
Name:PARKER, JUDITH M (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:PARKER
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 TIMBERLINE LN
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-6032
Mailing Address - Country:US
Mailing Address - Phone:903-821-4044
Mailing Address - Fax:
Practice Address - Street 1:1712 TIMBERLINE LN
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-6032
Practice Address - Country:US
Practice Address - Phone:903-821-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1063392OtherCIGNA
TX337165OtherMHN MANAGED HEALTHNETWORK