Basic Information
Provider Information
NPI: 1366767949
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARRISH
FirstName: DONNA
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1502 W NC HIGHWAY 54
Address2: STE. 103
City: DURHAM
State: NC
PostalCode: 277075571
CountryCode: US
TelephoneNumber: 9194032122
FaxNumber: 9194014993
Practice Location
Address1: 1415 W NC HIGHWAY 54
Address2: STE. 207
City: DURHAM
State: NC
PostalCode: 277075577
CountryCode: US
TelephoneNumber: 9194012933
FaxNumber: 9194012994
Other Information
ProviderEnumerationDate: 04/07/2010
LastUpdateDate: 04/07/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XCOO2367NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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