Provider Demographics
NPI:1942282421
Name:PARKER, NANCY NOEL (LSCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:NOEL
Last Name:PARKER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:CAROL
Other - Last Name:NOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 N WACO AVE
Mailing Address - Street 2:STE 34
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-3928
Mailing Address - Country:US
Mailing Address - Phone:316-866-2674
Mailing Address - Fax:316-866-2674
Practice Address - Street 1:815 N WACO AVE
Practice Address - Street 2:STE 34
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-3928
Practice Address - Country:US
Practice Address - Phone:316-213-4018
Practice Address - Fax:316-213-4018
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
070364Medicare ID - Type Unspecified
R31177Medicare UPIN