Provider Demographics
NPI:1841152451
Name:PARRA, DAVID JESUS (LCADC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JESUS
Last Name:PARRA
Suffix:
Gender:M
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6209
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-6209
Mailing Address - Country:US
Mailing Address - Phone:800-545-9031
Mailing Address - Fax:
Practice Address - Street 1:2901 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-9119
Practice Address - Country:US
Practice Address - Phone:800-545-9031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-02
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY294669101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)