Provider Demographics
NPI:1245535046
Name:PARKER, JOSEPH EZEKIEL (LMHC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:EZEKIEL
Last Name:PARKER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1809
Mailing Address - Country:US
Mailing Address - Phone:317-670-6180
Mailing Address - Fax:
Practice Address - Street 1:6011 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1809
Practice Address - Country:US
Practice Address - Phone:317-670-6180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002228A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health