Provider Demographics
NPI:1710744990
Name:PARKINSON, IRIS
Entity type:Individual
Prefix:DR
First Name:IRIS
Middle Name:
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 CHELSEA RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1054
Mailing Address - Country:US
Mailing Address - Phone:215-284-7055
Mailing Address - Fax:
Practice Address - Street 1:1722 CHELSEA RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1054
Practice Address - Country:US
Practice Address - Phone:215-284-7055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH006869103K00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty