Provider Demographics
NPI:1255664033
Name:PARSON, FAIRLEY MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:FAIRLEY
Middle Name:MARIE
Last Name:PARSON
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 1:238 SAN CARLOS ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1724
Mailing Address - Country:US
Mailing Address - Phone:415-915-7200
Mailing Address - Fax:
Practice Address - Street 1:582 MARKET ST STE 414
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-5324
Practice Address - Country:US
Practice Address - Phone:415-915-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA766241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical