Mary Christine Parks, LCSW, LCAS, ICAADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C006623 Issued in NC

Practice address

4302 Wrightsville Ave
Suite 1
Wilmington, NC 28403-6336

Phone

(910) 622-7204

Fax

(910) 401-1423

NPI assigned

Jan 7, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1356688758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 WRIGHTSVILLE AVE",
            "address_2": "SUITE 1",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036336",
            "telephone_number": "910-622-7204",
            "fax_number": "910-401-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 WRIGHTSVILLE AVE",
            "address_2": "SUITE 1",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036336",
            "telephone_number": "910-622-7204",
            "fax_number": "910-401-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCAS, ICAADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1505",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Jeffrey Louis Parker
• Parkhurst and Belisle, DDS, PLLC
• Jorey Edward Parkhurst, DDS
• John Parkinson, MD
• Christopher D Parks, MD
• Kathleen Corn Parnell, MSW LCSW
• Robert Alexander Parr, DO
• Amy Parrish, LMBT
• Jesse Parrish
• Lauren Michelle Parrish, MSW, LCSWA

• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.