Provider Demographics
NPI:1518427939
Name:PARRIS, JOANNA LEE (DBH NCC LISAC)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:LEE
Last Name:PARRIS
Suffix:
Gender:F
Credentials:DBH NCC LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15136
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-5136
Mailing Address - Country:US
Mailing Address - Phone:602-471-0751
Mailing Address - Fax:
Practice Address - Street 1:3408 E GARFIELD ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6228
Practice Address - Country:US
Practice Address - Phone:602-471-0751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10846101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)