Theron Reginald Parks, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60838935 Issued in WA

Practice address

721 Fawcett Ave
Tacoma, WA 98402-5502

Phone

(253) 284-7820

NPI assigned

Dec 7, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1467923003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 FAWCETT AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 FAWCETT AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025502",
            "telephone_number": "253-284-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "THERON",
        "middle_name": "REGINALD",
        "name_prefix": "Mr.",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-07",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60838935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Warren Parkison, LSWAIC
• Steven Charles Parkison, PH.D.
• Parkland Eye & Vision Clinic, PLLC
• Parkland Physical Therapy, PLLC
• Stephanie M Parks, RPH
• Brett Alayne Parmenter, PH.D.
• Sarah L Parr, RN
• Denise Quinn Parra, DNP, ARNP
• Evelinda E. Parreno, MA
• Jennifer Michelle Parretta, LMFT, CST, ATR

• Addiction (Substance Use Disorder) Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.