Provider Demographics
NPI:1164678934
Name:PARKER, PRINCESS ELAINE
Entity type:Individual
Prefix:MRS
First Name:PRINCESS
Middle Name:ELAINE
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LOCUST AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1640
Mailing Address - Country:US
Mailing Address - Phone:973-760-7257
Mailing Address - Fax:973-639-0620
Practice Address - Street 1:567 PARK AVE
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1754
Practice Address - Country:US
Practice Address - Phone:973-639-1699
Practice Address - Fax:973-639-0620
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00391000101YP2500X
NJ37FI00165300106H00000X
NY000439106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional