MEDICARE: JESSE PARRISH

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	P020572	NC

General Provider Information

NPI Number	:	1356181994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE PARRISH

Provider Business Mailing Address
First Line	:	5904 OSPREY COVE DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-4356
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7621 PURFOY RD
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-6985
Country	:	US
Telephone Number	:	919-355-9792
Fax Number	:

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

Provider Enumeration Date	:	05/30/2024
Last Update Date	:	05/30/2024

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Directions to “ JESSE PARRISH ” Practice Location

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