=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730637216
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOELLE KING-PARRISH RN, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2016
-----------------------------------------------------
Last Update Date | 03/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2149 JOLLY RD STE 500
-----------------------------------------------------
City | OKEMOS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48864-6028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-347-4645
-----------------------------------------------------
Fax | 517-347-4644
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7408 PLAYERS CLUB DR
-----------------------------------------------------
City | LANSING
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48917-9656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-667-8175
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 6401223880
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 4704202723
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------