Provider Demographics
NPI:1356593313
Name:PARKER, WILLIAM
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:WILLIAM
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:817 BROADWAY FL 9
Mailing Address - Street 2:SUITE15
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4709
Mailing Address - Country:US
Mailing Address - Phone:212-242-0971
Mailing Address - Fax:212-242-0971
Practice Address - Street 1:817 BROADWAY FL 9
Practice Address - Street 2:SUITE15
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4709
Practice Address - Country:US
Practice Address - Phone:212-242-0971
Practice Address - Fax:212-242-0971
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0478351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical