Healthcare Provider Details

I. General information

NPI: 1306022926
Provider Name (Legal Business Name): ANDREAS J PARSLEY SR. BA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 01/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 ENTERPRISE DR
VASSAR MI
48768-9584
US

IV. Provider business mailing address

115 UNIONVILLE INDIAN TRAIL RD W STE A-7
INDIAN TRAIL NC
28079-5583
US

V. Phone/Fax

Practice location:
  • Phone: 989-823-3040
  • Fax:
Mailing address:
  • Phone: 704-665-5583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCSAC20375
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCSAC20375
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: