Provider Demographics
NPI:1922052307
Name:STOREY, PARKER L (PHD)
Entity Type:Individual
Prefix:
First Name:PARKER
Middle Name:L
Last Name:STOREY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 OFFICE PARK CIR
Mailing Address - Street 2:STE 310
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2536
Mailing Address - Country:US
Mailing Address - Phone:205-601-9466
Mailing Address - Fax:
Practice Address - Street 1:3 OFFICE PARK CIR
Practice Address - Street 2:STE 310
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2536
Practice Address - Country:US
Practice Address - Phone:205-601-9466
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL888103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051077541OtherBCBS OF AL
AL000077541Medicaid