Provider Demographics
NPI:1992203301
Name:BLANEY, PARKER N JR (LCPC)
Entity Type:Individual
Prefix:
First Name:PARKER
Middle Name:N
Last Name:BLANEY
Suffix:JR
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 OSSIPEE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WATERBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04087-3481
Mailing Address - Country:US
Mailing Address - Phone:207-337-0828
Mailing Address - Fax:
Practice Address - Street 1:16 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1011
Practice Address - Country:US
Practice Address - Phone:207-351-2118
Practice Address - Fax:207-351-2189
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC6586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional