Provider Demographics
NPI:1891871588
Name:PARKER, JENNIFER CAROL (MSSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:CAROL
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 N PINCKNEY ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-1410
Mailing Address - Country:US
Mailing Address - Phone:608-255-8838
Mailing Address - Fax:608-255-8837
Practice Address - Street 1:406 N PINCKNEY ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-1410
Practice Address - Country:US
Practice Address - Phone:608-255-8838
Practice Address - Fax:608-255-8837
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1356-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical