Provider Demographics
NPI:1295507283
Name:PARKER, ELISABETH KATHRYN (MSW, MRT, IAYT)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:KATHRYN
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSW, MRT, IAYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SHEPARD AVE UPPR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1952
Mailing Address - Country:US
Mailing Address - Phone:716-263-6626
Mailing Address - Fax:
Practice Address - Street 1:8610 TRANSIT RD STE 500
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-2613
Practice Address - Country:US
Practice Address - Phone:716-458-0382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health