Provider Demographics
NPI:1306018700
Name:PARRISH, HAZEL DELL (CADC)
Entity Type:Individual
Prefix:MRS
First Name:HAZEL
Middle Name:DELL
Last Name:PARRISH
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:HAZEL
Other - Middle Name:DELL
Other - Last Name:BRELAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCADC
Mailing Address - Street 1:1115 GARVIN PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-3178
Mailing Address - Country:US
Mailing Address - Phone:502-417-2566
Mailing Address - Fax:
Practice Address - Street 1:1115 GARVIN PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-3178
Practice Address - Country:US
Practice Address - Phone:502-417-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1078101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)