| Parks Associates, P.c. | |
|
6337 Central Ave Portage IN 46368-3801 | |
| (219) 763-1499 | |
| (219) 764-7025 |
| Full Name | Parks Associates, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 6337 Central Ave, Portage, Indiana |
| Authorized Official Name and Position | David W. Parks (PRESIDENT) |
| Authorized Official Contact | 2197631499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parks Associates, P.c. 6337 Central Ave Portage IN 46368-3801 Ph: (219) 763-1499 | Parks Associates, P.c. 6337 Central Ave Portage IN 46368-3801 Ph: (219) 763-1499 |
| NPI Number | 1518126721 |
|---|---|
| Provider Enumeration Date | 06/03/2008 |
| Last Update Date | 06/03/2008 |
| Medicare PECOS PAC ID | 0749404945 |
|---|---|
| Medicare Enrollment ID | O20140609001867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518126721 | NPI | - | NPPES |
| 200049630B | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 20040984A (Indiana) | Primary |
| Provider Name | David Parks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285702548 PECOS PAC ID: 3274429741 Enrollment ID: I20140610001605 |
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