Provider Demographics
NPI:1104053784
Name:PARKHURST, ALLISON M (LMFT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:M
Last Name:PARKHURST
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WESLEYAN AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-5109
Mailing Address - Country:US
Mailing Address - Phone:301-606-7455
Mailing Address - Fax:401-277-3366
Practice Address - Street 1:186 PROVIDENCE ST
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-2508
Practice Address - Country:US
Practice Address - Phone:401-615-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMFT00125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1021740OtherNHP/BEACON (GROUP)