Provider Demographics
NPI:1447925458
Name:PARKER, SHARON (MSW, LCAC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 206TH STREET
Mailing Address - Street 2:DYER, INDIANA 46311
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311
Mailing Address - Country:US
Mailing Address - Phone:219-427-3664
Mailing Address - Fax:219-864-7898
Practice Address - Street 1:642 206TH STREET
Practice Address - Street 2:DYER, INDIANA 46311
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-4631
Practice Address - Country:US
Practice Address - Phone:219-427-3664
Practice Address - Fax:219-864-7898
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87001273A101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical