Provider Demographics
NPI:1861672495
Name:PARKER, BETTY CHARLINE (LCSW)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:CHARLINE
Last Name:PARKER
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 1:573 COUNTY AVENUE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:AR
Mailing Address - Zip Code:72744
Mailing Address - Country:US
Mailing Address - Phone:479-824-3000
Mailing Address - Fax:479-824-3003
Practice Address - Street 1:573 COUNTY AVENUE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:AR
Practice Address - Zip Code:72744
Practice Address - Country:US
Practice Address - Phone:479-824-3000
Practice Address - Fax:479-824-3003
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2813-B104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker