MICHELLE WRAYANNE GLAZE PARKER (NPI# 1760092019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760092019 |
| Entity Type | Individual |
| Full Name | MICHELLE WRAYANNE GLAZE PARKER |
| Credential | LPC |
| Practice Address |
700 Churchill Ct Ste 110 Woodstock GA 30188-6880 |
| Mailing Address |
40 Gold Creek Dr Tallapoosa GA 30176-4339 |
| Practice Telephone | 7702849092 |
| Mailing Telephone | 4043722885 |
| Enumeration Date | 2020-08-02 |
| Last Update Date | 2020-08-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
509931 | GA | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC011567 | GA | Behavioral Health & Social Service Providers |
| Street Address |
700 CHURCHILL CT STE 110 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30188-6880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457901340 | Esfahani Enterprises LLC | Counselor | 700 Churchill Ct Ste 110, Woodstock, GA 30188-6880 | 2019-09-12 |
| 1053929786 | Thriveworks Woodstock | Clinic/Center | 700 Churchill Ct Ste 110, Woodstock, GA 30188-6880 | 2020-07-20 |
| 1295357028 | Deshawn Renarda Artis | Counselor | 700 Churchill Ct Ste 110, Woodstock, GA 30188-6880 | 2020-05-14 |
| 1205479490 | Jacqueline Alexandra Lilly | Counselor | 700 Churchill Ct Ste 110, Woodstock, GA 30188-6880 | 2019-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1881224897 | Dr. Tom LLC | Clinic/Center | 5431 Old Highway 5 Ste 206, Holly Springs, GA 30188 | 2020-01-17 |
| 1467090175 | Stacey Robin Hill | Dietitian, Registered | 210 Mcaffee St, Street Address 2, Woodstock, GA 30188 | 2019-12-12 |
| 1326681784 | Margo Vanderveen | Massage Therapist | 605 Old Hickory Road, Woodstock, GA 30188 | 2019-10-17 |
| 1275093437 | Rebekah Ruth Tchouta | Social Worker | 5166 Shotwell St, Woodstock, GA 30188 | 2019-03-23 |
| 1205395829 | Angela M Graves | Behavior Technician | 3229 S Cherokee Ln Ste 1400, Woodstock, GA 30188 | 2019-03-13 |
| 1396233391 | Costco Wholesale Corporation | Hearing Aid Equipment | 113 Lincoln Street, Woodstock, GA 30188 | 2018-04-25 |
| 1659878080 | Alexis K. Brown | Counselor | 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 | 2018-04-11 |
| 1427555440 | Lisa Marie Anthony | Specialist/Technologist | 400 Arnold Mill Rd, Woodstock, GA 30188 | 2018-04-06 |
| 1497254122 | J.a.h. Enterprises, LLC | Audiologist | 12195 Hwy. 92, Suite 114-325, Woodstock, GA 30188 | 2018-02-08 |
| Find all providers in zip 30188 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134736788 | Lana Mcnair | Counselor | 970 Woodstock Pkwy Ste 210, Woodstock, GA 30188-4869 | 2020-09-28 |
| 1336755537 | Leslie Phillos Duckett | Counselor | 208 River Park North Dr, Woodstock, GA 30188-7834 | 2020-09-22 |
| 1871064758 | Nazila Aghazadeh | Counselor | 237 Colony Center Dr, Woodstock, GA 30188-4697 | 2018-12-17 |
| 1437638954 | Atlanta Counseling Insight, LLC | Counselor | 115 Piedmont Ln, Woodstock, GA 30189-7051 | 2018-08-07 |
| 1659878080 | Alexis K. Brown | Counselor | 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 | 2018-04-11 |
| 1821478009 | Georgia Counseling Center Inc | Counselor | 335 Parkway 575 Ste 301, Woodstock, GA 30188-6433 | 2015-06-03 |
| 1952781239 | Barry James Bouillion Jr. | Counselor | 3380 Trickum Rd Bldg 700, Woodstock, GA 30188-3680 | 2015-06-02 |
| 1952790727 | Tiffanie Wigstrom Williams | Counselor | 3380 Trickum Rd., Building 1000, Suite 102, Woodstock, GA 30188 | 2015-01-16 |
| 1952710337 | Grounding Flight | Counselor | 136 Pioneer Dr, Woodstock, GA 30188-4522 | 2014-08-11 |
| 1790111631 | Richard Lee Mccoy | Counselor | 134 Cass St Ste 3, Woodstock, IL 60098-3208 | 2013-09-24 |
| Find all providers in WOODSTOCK | ||||
Please comment or provide details below to improve the information on MICHELLE WRAYANNE GLAZE 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.