Provider Demographics
NPI:1174791719
Name:PARISH, DAWN NICOLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:NICOLE
Last Name:PARISH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:PARISH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:100 W COURT AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3502
Mailing Address - Country:US
Mailing Address - Phone:812-288-5044
Mailing Address - Fax:812-288-8801
Practice Address - Street 1:100 W COURT AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3502
Practice Address - Country:US
Practice Address - Phone:812-288-5044
Practice Address - Fax:812-288-8801
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005573A1041C0700X
KY33621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical