Healthcare Provider Details

I. General information

NPI: 1689705048
Provider Name (Legal Business Name): MERSHONA PARSHALL LCSW, LISW, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 SANGRE DE CRISTO
CEDAR CREST NM
87008-9402
US

IV. Provider business mailing address

144 SANGRE DE CRISTO
CEDAR CREST NM
87008-9402
US

V. Phone/Fax

Practice location:
  • Phone: 440-786-9838
  • Fax:
Mailing address:
  • Phone: 440-786-9838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-0009397
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number11047
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16808
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: