Provider Demographics
NPI:1962654509
Name:MARLENE PARKER, PSY.D.,HSPP,P.C.
Entity Type:Organization
Organization Name:MARLENE PARKER, PSY.D.,HSPP,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, HSPP
Authorized Official - Phone:765-506-2215
Mailing Address - Street 1:538 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-3767
Mailing Address - Country:US
Mailing Address - Phone:765-506-2215
Mailing Address - Fax:765-662-6482
Practice Address - Street 1:538 W 1ST ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-3767
Practice Address - Country:US
Practice Address - Phone:765-506-2215
Practice Address - Fax:765-662-6482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041950A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty