MR. BRODERICK PARKER (NPI# 1154538932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154538932 |
| Entity Type | Individual |
| Full Name | MR. BRODERICK PARKER |
| Credential | MHPP |
| Practice Address |
20400 Col. Glenn Rd. Little Rock AR 72210-5323 |
| Mailing Address |
20400 Col.glenn Rd. Little Rock AR 72210-5323 |
| Practice Telephone | 5018215500 |
| Practice Fax Number | 5018217068 |
| Mailing Telephone | 5018215500 |
| Mailing Fax Number | 5018217068 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2010-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| Street Address |
20400 COL. GLENN RD. |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72210-5323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699890772 | Vernon Harris | Counselor | 20400 Col. Glenn Rd., Little Rock, AR 72210-5323 | 2007-03-20 |
| 1912147695 | Joey V Simmons I | Counselor | 20400 Col. Glenn Rd., Little Rock, AR 72210-5323 | 2009-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487290888 | John Hunter Bramlitt | Counselor | 12320 I-30, Little Rock, AR 72210 | 2019-11-20 |
| 1972159267 | Arkansas Baptist Children's Homes and Family Ministries | Counselor | 12400 I-30, Little Rock, AR 72210 | 2019-08-13 |
| 1952956864 | Hanrietta Evans | Behavior Technician | Youth Home Inc, 20302 Colonel Glenn Rd, Little Rock, AR 72210 | 2019-08-07 |
| 1821597287 | Deanna Smith | Counselor | 12320 I-30 Frontage Road, Little Rock, AR 72210 | 2018-02-12 |
| 1922485481 | Whitney Brown | Social Worker | 20400 Colonel Glenn, Little Rock, AR 72210 | 2015-05-04 |
| 1679978191 | Jennifer Black | Counselor | 20302 Col Glenn Road, Little Rock, AR 72210 | 2014-10-27 |
| 1831593896 | James William Takach | Family Medicine | 14519 Wimbledon Loop, Little Rock, AR 72210 | 2014-10-20 |
| 1811319734 | Ben Malone | Case Manager/Care Coordinator | 20400 Col Glenn Road, Little Rock, AR 72210 | 2014-01-12 |
| 1487924296 | Tara Brown | Case Manager/Care Coordinator | 20302 Colonel Glenn Rd., Little Rock, AR 72210 | 2012-01-10 |
| 1972889061 | D. Rachelle Rial | Case Manager/Care Coordinator | 20400 Col Glenn Rd., Little Rock, AR 72210 | 2011-11-02 |
| Find all providers in zip 72210 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003425703 | Apollo Health, LLC | Counselor | 11715 Rainwood Rd Ste B6, Little Rock, AR 72212-3968 | 2020-07-28 |
| 1376168120 | Shea Wood | Counselor | 8 Shackleford Plz Ste 206, Little Rock, AR 72211-1853 | 2020-06-08 |
| 1740803683 | Ryan Russ LLC | Counselor | 1900 N Bryant St Ste 310, Little Rock, AR 72207-5022 | 2020-05-27 |
| 1003443953 | David Laser Jr. | Counselor | 3700 W 65th St, Little Rock, AR 72209-8552 | 2020-03-23 |
| 1992331508 | Seth Thomas Gilleran | Counselor | 14710 Cantrell Rd Ste 7a, Little Rock, AR 72223-4253 | 2020-03-14 |
| 1568004240 | Cheyenne Parker | Counselor | 20400 Col Glenn Road Youth Home, Inc., Little Rock, AR 72210-5323 | 2019-10-14 |
| 1104473198 | Carrie Teresa Calhoon | Counselor | 1100 N University Ave Ste 137, Little Rock, AR 72207-6344 | 2019-08-23 |
| 1730668864 | Raysha Clark | Counselor | 10515 W Markham St Ste K4, Little Rock, AR 72205-2287 | 2018-08-09 |
| 1003306804 | Chris Beasley | Counselor | 9819 Margie Cir, Little Rock, AR 72209-6521 | 2018-05-16 |
| 1841787090 | Martin Counseling Services, LLC | Counselor | 1100 N University Ave Ste 210, Little Rock, AR 72207-6359 | 2018-04-13 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72210 |
Please comment or provide details below to improve the information on MR. BRODERICK PARKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.