Provider Demographics
NPI:1831577279
Name:PARKER, CHARIS D (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHARIS
Middle Name:D
Last Name:PARKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHARIS
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1400 SW SUSANA ST STE 12
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72713-7877
Mailing Address - Country:US
Mailing Address - Phone:479-203-7100
Mailing Address - Fax:
Practice Address - Street 1:1400 SW SUSANA ST STE 12
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72713-7877
Practice Address - Country:US
Practice Address - Phone:479-203-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2110004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health