Provider Demographics
NPI:1528571312
Name:PARSONS, SETH (CDCA)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:PARSONS
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 PRIVATE DRIVE 339
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680-8919
Mailing Address - Country:US
Mailing Address - Phone:304-208-3273
Mailing Address - Fax:
Practice Address - Street 1:48 PRIVATE DRIVE 339
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-8919
Practice Address - Country:US
Practice Address - Phone:304-208-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.163236101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator