Active NPI
Judy Dianne Parks, LCSW-C
- Clinical Social Worker
- Randallstown, MD
National Provider Identifier
1235366766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14414
- Practice address
- 9012 Lesan Rd
Randallstown, MD 21133-3622 - Phone
- (410) 922-4723
- NPI assigned
- Jun 11, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 14414 | MD | Primary |
Addresses
Primary practice location
9012 Lesan Rd
Randallstown, MD 21133-3622
Mailing address
9012 Lesan Rd
Randallstown, MD 21133-3622
Phone (410) 922-4723
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14414 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244678400000",
"number": "1235366766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9012 LESAN RD",
"city": "RANDALLSTOWN",
"state": "MD",
"postal_code": "211333622",
"telephone_number": "410-922-4723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9012 LESAN RD",
"city": "RANDALLSTOWN",
"state": "MD",
"postal_code": "211333622",
"telephone_number": "410-922-4723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "JUDY",
"middle_name": "DIANNE",
"name_prefix": "Mrs.",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-11",
"last_updated": "2009-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "14414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randallstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.