Provider Demographics
NPI:1134786304
Name:PARKER, TONI R (LCSW-C)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:R
Last Name:PARKER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:R
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:1226 WOODBOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-3332
Mailing Address - Country:US
Mailing Address - Phone:443-432-9121
Mailing Address - Fax:
Practice Address - Street 1:600 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-5104
Practice Address - Country:US
Practice Address - Phone:410-693-2728
Practice Address - Fax:410-602-5108
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty