Provider Demographics
NPI:1952771610
Name:PARKER, LETA (PHD, LCSW, LGSW)
Entity Type:Individual
Prefix:DR
First Name:LETA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHD, LCSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1698 HAPAKI ST
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-1736
Mailing Address - Country:US
Mailing Address - Phone:808-294-8982
Mailing Address - Fax:
Practice Address - Street 1:98-1698 HAPAKI ST
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-1736
Practice Address - Country:US
Practice Address - Phone:808-294-8982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI39621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical