Provider Demographics
NPI:1407969439
Name:PARRISH, MARY ANNE (LCSW, CAC III)
Entity Type:Individual
Prefix:MS
First Name:MARY ANNE
Middle Name:
Last Name:PARRISH
Suffix:
Gender:F
Credentials:LCSW, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MADISON ST STE 204
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5411
Mailing Address - Country:US
Mailing Address - Phone:303-322-6997
Mailing Address - Fax:303-377-2093
Practice Address - Street 1:90 MADISON ST STE 204
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5411
Practice Address - Country:US
Practice Address - Phone:303-322-6997
Practice Address - Fax:303-377-2093
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCAC 1577101YA0400X
CO9897291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60276Medicare PIN