Provider Demographics
NPI:1932793841
Name:PARKER-EDWARDS, CHARLETTE (MA, CMHC, CMFT)
Entity Type:Individual
Prefix:MRS
First Name:CHARLETTE
Middle Name:
Last Name:PARKER-EDWARDS
Suffix:
Gender:F
Credentials:MA, CMHC, CMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 CALLENDER ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-3230
Mailing Address - Country:US
Mailing Address - Phone:617-480-0345
Mailing Address - Fax:
Practice Address - Street 1:1304 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-3747
Practice Address - Country:US
Practice Address - Phone:617-785-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106H00000X, 101YM0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program