Provider Demographics
NPI:1457232845
Name:GREG PARKER LLC
Entity type:Organization
Organization Name:GREG PARKER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-636-0912
Mailing Address - Street 1:2500 PALERMO DR STE 5
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-7206
Mailing Address - Country:US
Mailing Address - Phone:814-636-0912
Mailing Address - Fax:814-616-7400
Practice Address - Street 1:2500 PALERMO DR STE 5
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-7206
Practice Address - Country:US
Practice Address - Phone:814-636-0912
Practice Address - Fax:814-616-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty