Provider Demographics
NPI:1871081612
Name:PARKS, RHONDA FAYE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:FAYE
Last Name:PARKS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3504
Mailing Address - Country:US
Mailing Address - Phone:812-639-2054
Mailing Address - Fax:812-482-9220
Practice Address - Street 1:509 3RD AVE
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3504
Practice Address - Country:US
Practice Address - Phone:812-639-2054
Practice Address - Fax:812-482-9220
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003104A101YM0800X
IN88000119A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health