Provider Demographics
NPI:1184152332
Name:PARKS, BRAD WILLIAM (LCSW)
Entity type:Individual
Prefix:MR
First Name:BRAD
Middle Name:WILLIAM
Last Name:PARKS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E SOLA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2211
Mailing Address - Country:US
Mailing Address - Phone:805-705-0512
Mailing Address - Fax:808-568-0693
Practice Address - Street 1:510 E SOLA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2211
Practice Address - Country:US
Practice Address - Phone:805-705-0512
Practice Address - Fax:808-568-0693
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA177091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical