Provider Demographics
NPI:1932652195
Name:PARKER, MILLICENT (LPC)
Entity Type:Individual
Prefix:
First Name:MILLICENT
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 OLD ALABAMA RD
Mailing Address - Street 2:SUITE 119-109
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5860
Mailing Address - Country:US
Mailing Address - Phone:770-464-5123
Mailing Address - Fax:
Practice Address - Street 1:145 AUTRY ST
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1919
Practice Address - Country:US
Practice Address - Phone:770-464-5123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-24
Last Update Date:2016-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008548101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health