Provider Demographics
NPI:1235014283
Name:PARKS, KEVIN LAMONT
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:LAMONT
Last Name:PARKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 JESSAMINE ST
Mailing Address - Street 2:KEVINPARKS0912@GMAIL.COM
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-3793
Mailing Address - Country:US
Mailing Address - Phone:865-255-8063
Mailing Address - Fax:
Practice Address - Street 1:211 JESSAMINE ST
Practice Address - Street 2:KEVINPARKS0912@GMAIL.COM
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-3793
Practice Address - Country:US
Practice Address - Phone:865-255-8063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor