Provider Demographics
NPI:1982013371
Name:PARISH, ANDREW WERNER (LMHC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:WERNER
Last Name:PARISH
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 SUNSET COVE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-1783
Mailing Address - Country:US
Mailing Address - Phone:863-412-2626
Mailing Address - Fax:
Practice Address - Street 1:141 E CENTRAL AVE
Practice Address - Street 2:SUITE 240A
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-6338
Practice Address - Country:US
Practice Address - Phone:863-206-9428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12760101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health