Provider Demographics
NPI:1184221905
Name:PARSONS, MARISSA (LMSW)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:PARSONS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 CHENANGO ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-1653
Mailing Address - Country:US
Mailing Address - Phone:607-772-6904
Mailing Address - Fax:607-723-2617
Practice Address - Street 1:1182 CHENANGO ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-1653
Practice Address - Country:US
Practice Address - Phone:607-772-6904
Practice Address - Fax:607-723-2617
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02997780Medicaid