Provider Demographics
NPI:1851601470
Name:PARRISH, ANTHONY DENIS (LISAC)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:DENIS
Last Name:PARRISH
Suffix:
Gender:M
Credentials:LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5954 W GOLDEN LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-4555
Mailing Address - Country:US
Mailing Address - Phone:602-451-9735
Mailing Address - Fax:
Practice Address - Street 1:5954 W GOLDEN LN
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4555
Practice Address - Country:US
Practice Address - Phone:602-451-9735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1381101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)