Provider Demographics
NPI:1134684756
Name:PARKER, BILLY (LCSW)
Entity type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:PARKER
Suffix:
Gender:X
Credentials:LCSW
Other - Prefix:
Other - First Name:BILLY
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1118 S 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2440
Mailing Address - Country:US
Mailing Address - Phone:917-818-0448
Mailing Address - Fax:
Practice Address - Street 1:1118 S 23RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-2440
Practice Address - Country:US
Practice Address - Phone:917-818-0448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0935621041C0700X
PACW0210111041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical