Provider Demographics
NPI:1871814954
Name:PARKER, DAISY C (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:DAISY
Middle Name:C
Last Name:PARKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MISS
Other - First Name:DAISY
Other - Middle Name:V
Other - Last Name:CERQUEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:10 CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7938
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7938
Practice Address - Country:US
Practice Address - Phone:978-818-6751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-12
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA1173451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor