Individual
MADELON JEAN PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
455 CONCORD RD, FLETCHER, NC 28732-9734
(828) 329-8306
(828) 258-3831
Mailing address
455 CONCORD RD, FLETCHER, NC 28732-9734
(828) 329-8306
(828) 258-3831
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2915
NC
103TC0700X
Clinical Psychologist
2915
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045YF
BCBSNC
NC
01
—
108059
VALUE OPTIONS
NC
05
—
6000594
—
NC
01
—
C8053
MEDCOST
NC
01
—
U02489965
CIGNA BEHAVIORAL
NC
Enumeration date
03/31/2006
Last updated
05/25/2011
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