Provider Demographics
NPI:1538544788
Name:PARKER, DALE (MA, LCPC)
Entity type:Individual
Prefix:MR
First Name:DALE
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:MA, LCPC
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 444
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MT
Mailing Address - Zip Code:59825-0444
Mailing Address - Country:US
Mailing Address - Phone:432-266-8668
Mailing Address - Fax:
Practice Address - Street 1:12508 CRAMER CREEK RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MT
Practice Address - Zip Code:59825-9332
Practice Address - Country:US
Practice Address - Phone:432-266-8668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67007101YP2500X
MT38930101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional