MEDICARE: CHRISTOPHER PHILLIP PARRY LSW

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	225400000X	Rehabilitation Practitioner
2	104100000X	Social Worker	6970-M	NV

General Provider Information

NPI Number	:	1316637556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER PHILLIP PARRY LSW

Provider Business Mailing Address
First Line	:	8888 N GRAND CANYON DR UNIT 2003
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-6816
Country	:	US
Telephone Number	:	801-661-6658
Fax Number	:

Provider Business Practice Location Address
First Line	:	8888 N GRAND CANYON DR UNIT 2003
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-6816
Country	:	US
Telephone Number	:	801-661-6658
Fax Number	:

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

Provider Enumeration Date	:	05/10/2023
Last Update Date	:	06/17/2025

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