Jacqueline S Parker, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22663 Issued in TX

Practice address

4524 Boat Club Rd
Suite 188
Fort Worth, TX 76135-7025

Phone

(817) 487-6775

Fax

(817) 236-3827

NPI assigned

May 16, 2007

Last updated

Apr 27, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ms. Jacqueline S Riley Former name

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272326400000",
    "number": "1386850014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 MILL CREEK TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761795018",
            "telephone_number": "817-487-6775",
            "fax_number": "817-236-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4524 BOAT CLUB RD",
            "address_2": "SUITE 188",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357025",
            "telephone_number": "817-487-6775",
            "fax_number": "817-236-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JACQUELINE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "22663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149304101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "464056",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "109828513",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "RILEY",
            "middle_name": "S",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Marie Parker, PHARMD
• Casey Parker, PA-C
• Catherine J. Parker
• Diana Parker, OTR
• Heather Parker
• James F Parker, MD
• Kenneth Wayne Parker, D.C.
• Leighton Brown Parker, M.D.
• Lindsay Liebreich Parker
• Lisa D Parker, R.D., L.D.

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; 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.