MEDICARE: GREGORY PARRISH LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	7603-123	WI

General Provider Information

NPI Number	:	1083934897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY PARRISH LCSW

Provider Business Mailing Address
First Line	:	1845 N FARWELL AVE
Second Line	:	SUITE 310
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-1793
Country	:	US
Telephone Number	:	414-745-6707
Fax Number	:	414-240-4232

Provider Business Practice Location Address
First Line	:	1845 N FARWELL AVE STE 310
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-1715
Country	:	US
Telephone Number	:	414-745-6707
Fax Number	:	414-240-4232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	07/21/2022

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