Provider Demographics
NPI:1952112922
Name:PARKER, JAYELIN NICOLE (LLMSW, MPH)
Entity type:Individual
Prefix:
First Name:JAYELIN
Middle Name:NICOLE
Last Name:PARKER
Suffix:
Gender:F
Credentials:LLMSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5175 WOODLANE RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-3163
Mailing Address - Country:US
Mailing Address - Phone:248-860-9446
Mailing Address - Fax:
Practice Address - Street 1:33 E ADAMS AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-1602
Practice Address - Country:US
Practice Address - Phone:248-860-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511192501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical