Provider Demographics
NPI:1255771242
Name:PARRISH, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:PARRISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 GUM BRANCH RD
Mailing Address - Street 2:SUITE O
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-6272
Mailing Address - Country:US
Mailing Address - Phone:910-389-4034
Mailing Address - Fax:910-989-0377
Practice Address - Street 1:824 GUM BRANCH RD
Practice Address - Street 2:SUITE O
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-6272
Practice Address - Country:US
Practice Address - Phone:910-389-4034
Practice Address - Fax:910-989-0377
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0097031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical