Healthcare Provider Details

I. General information

NPI: 1679132104
Provider Name (Legal Business Name): EMERALD JOYDELLE PARISI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2019
Last Update Date: 06/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E DIVISION ST
HARLOWTON MT
59036-5157
US

IV. Provider business mailing address

205 RED FOX RD
JUDITH GAP MT
59453-8201
US

V. Phone/Fax

Practice location:
  • Phone: 406-220-0707
  • Fax:
Mailing address:
  • Phone: 406-220-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBBH-LCSW-LIC-38036
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: