Provider Demographics
NPI:1205518800
Name:PARKS PSYCHOTHERAPY, PLLC
Entity type:Organization
Organization Name:PARKS PSYCHOTHERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:323-316-6661
Mailing Address - Street 1:1037 NE 65TH ST # 80485
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6655
Mailing Address - Country:US
Mailing Address - Phone:323-740-0487
Mailing Address - Fax:
Practice Address - Street 1:221 1ST ST UNIT 304
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6169
Practice Address - Country:US
Practice Address - Phone:323-316-6661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health