Provider Demographics
NPI:1255371506
Name:CARROLL-PARKER, CATHERINE (PHD, LCSW-C)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:CARROLL-PARKER
Suffix:
Gender:F
Credentials:PHD, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19189 TARN LN
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-6000
Mailing Address - Country:US
Mailing Address - Phone:301-862-2022
Mailing Address - Fax:
Practice Address - Street 1:22325 GREENVIEW PKWY
Practice Address - Street 2:INNERWORKS, INC.
Practice Address - City:GREAT MILLS
Practice Address - State:MD
Practice Address - Zip Code:20634
Practice Address - Country:US
Practice Address - Phone:301-862-2202
Practice Address - Fax:301-862-2550
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD107581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical