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Individual

JIM PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
450 LANIER RD, MADISON, AL 35758-1866
(256) 774-4500
(256) 774-4573
Mailing address
450 LANIER RD, MADISON, AL 35758-1866
(256) 774-4500
(256) 774-4573

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0350C
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0350C
SOCIAL WORK LICENSE
AL
Enumeration date
08/03/2005
Last updated
04/07/2009
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