Provider Demographics
NPI:1356993851
Name:PARKS, ERIN (LCSW, LCADC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:PARKS
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:JACKSON PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LCADC
Mailing Address - Street 1:1460 SCRANTON AVE
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-3813
Mailing Address - Country:US
Mailing Address - Phone:732-890-0244
Mailing Address - Fax:
Practice Address - Street 1:85 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2437
Practice Address - Country:US
Practice Address - Phone:973-264-0023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046518001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical