Provider Demographics
NPI:1114327590
Name:PARRISH, BECKY LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:LYNN
Last Name:PARRISH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 FERNWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:FERN PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32730-2116
Mailing Address - Country:US
Mailing Address - Phone:407-792-9753
Mailing Address - Fax:
Practice Address - Street 1:237 FERNWOOD BLVD
Practice Address - Street 2:
Practice Address - City:FERN PARK
Practice Address - State:FL
Practice Address - Zip Code:32730-2116
Practice Address - Country:US
Practice Address - Phone:407-831-2411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL158731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty