Individual provider Active NPI

John Stephen Parker, MS

  • Mental Health Counselor
  • Wilmington, DE
National Provider Identifier
1962615252
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC-0000439 Issued in DE
Practice address
2601 Annand Dr Ste 20
Wilmington, DE 19808
Phone
(302) 898-9861
Fax
(610) 274-2209
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC-0000439 DE Primary
Clinical Psychologist 103TC0700X PS-006161-L PA
Counseling Psychologist 103TC1900X PS-006161-L PA

Addresses

Primary practice location

2601 Annand Dr Ste 20
Wilmington, DE 19808

Mailing address

2601 Annand Dr Ste 20
Wilmington, DE 19808-3719
Phone (302) 898-9861

Other practice location 1

515 W 18th St
Wilmington, DE 19802-4705
Phone (302) 898-9861

Other practice location 2

1 Kings Ct
Landenberg, PA 19350-9324
Phone (302) 898-9861

Other identifiers 4

IdentifierTypeStateIssuer
1962615252MedicaidDE
PS-006161-LOtherPALICENSED PSYCHOLOGIST
0013914540003MedicaidPA
1962615252OtherDELPCMH

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)
Enrolled
Credentials
Master of Education, Master of Science

State licenses

LicenseStateTypeSpecialty
PC-0000439DEMDMental Health Counselor
PS-006161-LPAMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1962615252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR STE 20",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719",
            "telephone_number": "302-898-9861",
            "fax_number": "610-274-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR STE 20",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19808",
            "telephone_number": "302-898-9861",
            "fax_number": "610-274-2209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 W 18th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198024705",
            "country_code": "US",
            "telephone_number": "302-898-9861",
            "fax_number": "610-274-2209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Kings Ct",
            "address_purpose": "LOCATION",
            "city": "Landenberg",
            "state": "PA",
            "postal_code": "193509324",
            "country_code": "US",
            "telephone_number": "302-898-9861",
            "fax_number": "610-274-2209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JOHN",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "PC-0000439",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-006161-L",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS-006161-L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962615252",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCHOLOGIST",
            "identifier": "PS-006161-L",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0013914540003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPCMH",
            "identifier": "1962615252",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.