Provider Demographics
NPI:1346977535
Name:PARROW, MATTHEW (LCPC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:PARROW
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12322 W DREYFUS DR
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-4217
Mailing Address - Country:US
Mailing Address - Phone:623-377-0226
Mailing Address - Fax:
Practice Address - Street 1:12322 W DREYFUS DR
Practice Address - Street 2:
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-4217
Practice Address - Country:US
Practice Address - Phone:623-377-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC12283101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional