Individual
KELLER PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2320 E NORTH ST, DD-103, GREENVILLE, SC 29607-1247
(864) 239-6900
(864) 242-0700
Mailing address
5715 HEWITT DR, CHARLOTTE, NC 28269-3028
(980) 250-4861
(864) 242-0700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
03/20/2016
Last updated
03/20/2016
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