Provider Demographics
NPI:1841563301
Name:PARKE, KATHRYN RUTTER (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:RUTTER
Last Name:PARKE
Suffix:
Gender:
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 LAKE MONTEBELLO TER
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-3132
Mailing Address - Country:US
Mailing Address - Phone:410-262-3469
Mailing Address - Fax:833-466-1766
Practice Address - Street 1:200 E JOPPA RD STE 203
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-3107
Practice Address - Country:US
Practice Address - Phone:410-262-3469
Practice Address - Fax:833-466-1766
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD143681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical