Provider Demographics
NPI:1124411657
Name:PARRIS, AMY K (LCSW, LISW, DBH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:PARRIS
Suffix:
Gender:F
Credentials:LCSW, LISW, DBH
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:K
Other - Last Name:DANSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11650 N. LANTERN ROAD
Mailing Address - Street 2:SUITE 232
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038
Mailing Address - Country:US
Mailing Address - Phone:317-954-7007
Mailing Address - Fax:
Practice Address - Street 1:11650 N. LANTERN ROAD
Practice Address - Street 2:SUITE 232
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038
Practice Address - Country:US
Practice Address - Phone:317-954-7007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-088011041C0700X
IN34007152A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical