Provider Demographics
NPI:1649448895
Name:PARKER, JON (LPC, LMHC, NCC)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:LPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 NW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-2835
Mailing Address - Country:US
Mailing Address - Phone:510-205-4659
Mailing Address - Fax:
Practice Address - Street 1:2603 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-2835
Practice Address - Country:US
Practice Address - Phone:678-310-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009958101YP2500X
FLMH19106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional