Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 2441 | KS |
Y | 103T00000X | Psychologist | 2441 | KS |
N | 102L00000X | Psychologist | 2981 | KS |
N | 103T00000X | Psychologist | 2981 | KS |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 035 | KS |
N | 103TA0700X | Adult Development & Aging Psychologist | 2441 | KS |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 2441 | KS |
N | 103TF0000X | Family Psychologist | ||
N | 103TF0200X | Forensic Psychologist | ||
N | 103TH0004X | Health Psychologist | ||
N | 103TP0814X | Psychoanalysis | 2441 | KS |
N | 103TP2701X | Group Psychotherapist | 2441 | KS |
NPI | 1568690923 |
---|---|
Provider Name | Dr. Derek M Parker |
First Address | Newton, KS 67114-0467 |
Second Address | Newton, KS 67114-5010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 20/04/2021 |