Provider Demographics
NPI:1164855417
Name:PARRISH, TERRY JEAN (LPC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:JEAN
Last Name:PARRISH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52188 VAN DYKE
Mailing Address - Street 2:103 AND 104
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316
Mailing Address - Country:US
Mailing Address - Phone:586-601-8000
Mailing Address - Fax:866-820-9394
Practice Address - Street 1:52188 VAN DYKE AVE
Practice Address - Street 2:103 AND 104
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-3567
Practice Address - Country:US
Practice Address - Phone:586-601-8000
Practice Address - Fax:866-820-9394
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011624101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional