Provider Demographics
NPI:1205344199
Name:PARRISH, KATHLEEN MARGARET (LPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARGARET
Last Name:PARRISH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:M
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:7221 E CLAYRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-6153
Mailing Address - Country:US
Mailing Address - Phone:520-971-0139
Mailing Address - Fax:
Practice Address - Street 1:1735 E FORT LOWELL RD STE 11
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2358
Practice Address - Country:US
Practice Address - Phone:520-971-0139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-14
Last Update Date:2018-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10377101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty