Provider Demographics
NPI:1396344388
Name:PARKER, CORINNE GIOIA (LCAS)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:GIOIA
Last Name:PARKER
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:MARIE
Other - Last Name:GIOIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCAS
Mailing Address - Street 1:808 SAINT ANDREWS DR APT B
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-8358
Mailing Address - Country:US
Mailing Address - Phone:631-560-4884
Mailing Address - Fax:
Practice Address - Street 1:106 4TH ST
Practice Address - Street 2:
Practice Address - City:BLADENBORO
Practice Address - State:NC
Practice Address - Zip Code:28320-9407
Practice Address - Country:US
Practice Address - Phone:910-613-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)