Provider Demographics
NPI:1649647769
Name:PARKER, CLINTON DOUGLAS (LPC, LPCC)
Entity type:Individual
Prefix:MR
First Name:CLINTON
Middle Name:DOUGLAS
Last Name:PARKER
Suffix:
Gender:
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 ALLEN ST APT 933
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-5979
Mailing Address - Country:US
Mailing Address - Phone:903-204-4088
Mailing Address - Fax:
Practice Address - Street 1:821 ALLEN ST APT 933
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-5979
Practice Address - Country:US
Practice Address - Phone:903-204-4088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16170101YP2500X
TX88209101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional