Provider Demographics
NPI:1396142832
Name:PARRIS, SOPHIA (LCSW)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:PARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:VISADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1011 SW EMKAY DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3162
Mailing Address - Country:US
Mailing Address - Phone:541-323-3477
Mailing Address - Fax:
Practice Address - Street 1:1011 SW EMKAY DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3162
Practice Address - Country:US
Practice Address - Phone:541-323-3477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-27
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL105551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical