Provider Demographics
NPI:1437928769
Name:PARKER, ANDREW DAVID (LMSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DAVID
Last Name:PARKER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2169 E ELLIS DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7457
Mailing Address - Country:US
Mailing Address - Phone:480-305-3357
Mailing Address - Fax:
Practice Address - Street 1:9389 E VIA DEL SOL DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5072
Practice Address - Country:US
Practice Address - Phone:480-590-4606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-218581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical