Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Diane Parks, MA, TLLP

Individual provider Psychologist · NPI 1194069500

Jacqueline Diane Parks, MA, TLLP is a Psychologist in Southgate, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2012
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

19291 Northline Rd
Southgate, MI 48195-2220
Phone: (734) 785-7700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 6301015305 (MI)

Record details

NPI number1194069500
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , TLLP
Sole proprietorYes
NPI enumeratedNovember 26, 2012
Last updated in NPPESNovember 26, 2012

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