Provider Demographics
NPI:1083934897
Name:PARRISH, GREGORY (LCSW)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:PARRISH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 N FARWELL AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1793
Mailing Address - Country:US
Mailing Address - Phone:414-745-6707
Mailing Address - Fax:414-240-4232
Practice Address - Street 1:1845 N FARWELL AVE STE 310
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1715
Practice Address - Country:US
Practice Address - Phone:414-745-6707
Practice Address - Fax:414-240-4232
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7603-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical