Individual
MR. JOHN STEPHEN PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
2601 ANNAND DR STE 20, WILMINGTON, DE 19808
(302) 898-9861
(610) 274-2209
Mailing address
2601 ANNAND DR STE 20, WILMINGTON, DE 19808-3719
(302) 898-9861
(610) 274-2209
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC-0000439
DE
103TC0700X
Clinical Psychologist
PS-006161-L
PA
103TC1900X
Counseling Psychologist
PS-006161-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013914540003
—
PA
01
—
1962615252
LPCMH
DE
05
—
1962615252
—
DE
01
—
PS-006161-L
LICENSED PSYCHOLOGIST
PA
Enumeration date
05/07/2007
Last updated
08/01/2018
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