Provider Demographics
NPI:1891263893
Name:PARRISH, AMBER NICOLE (LLPC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:PARRISH
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 ANITA AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1476
Mailing Address - Country:US
Mailing Address - Phone:734-664-9322
Mailing Address - Fax:
Practice Address - Street 1:29750 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-2607
Practice Address - Country:US
Practice Address - Phone:586-777-3200
Practice Address - Fax:586-777-7855
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI80597225800000X
MI6451022678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist