Provider Demographics
NPI:1811166895
Name:PARKER, WRENDA N (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:WRENDA
Middle Name:N
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-4811
Mailing Address - Country:US
Mailing Address - Phone:970-674-1662
Mailing Address - Fax:970-674-1641
Practice Address - Street 1:1105 WALNUT ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4811
Practice Address - Country:US
Practice Address - Phone:970-674-1662
Practice Address - Fax:970-674-1641
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO138101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO138OtherLICENSED PROFESSIONAL COU