Provider Demographics
NPI:1891977948
Name:PARCELL, DAVID JAY (BS, LBSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAY
Last Name:PARCELL
Suffix:
Gender:M
Credentials:BS, LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16500 N PARK DR
Mailing Address - Street 2:APT 620
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4735
Mailing Address - Country:US
Mailing Address - Phone:248-569-8585
Mailing Address - Fax:248-209-2695
Practice Address - Street 1:16500 N PARK DR
Practice Address - Street 2:APT 620
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4735
Practice Address - Country:US
Practice Address - Phone:248-569-8585
Practice Address - Fax:248-209-2695
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2055942104100000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No302R00000XManaged Care OrganizationsHealth Maintenance Organization