Provider Demographics
NPI:1902101504
Name:PARKER, TEMEKA (LICSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:TEMEKA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6742
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20792-6742
Mailing Address - Country:US
Mailing Address - Phone:202-288-1104
Mailing Address - Fax:
Practice Address - Street 1:1933 MONTANA AVENUE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1817
Practice Address - Country:US
Practice Address - Phone:202-288-1104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500789171041C0700X
MD157261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical