Provider Demographics
NPI:1669340154
Name:PARSONS, JERUSHA ELLEN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JERUSHA
Middle Name:ELLEN
Last Name:PARSONS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:JERI
Other - Middle Name:ELLEN
Other - Last Name:PARSONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:22 US OVAL STE 218
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12903-5902
Mailing Address - Country:US
Mailing Address - Phone:518-926-7100
Mailing Address - Fax:
Practice Address - Street 1:25 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5882
Practice Address - Country:US
Practice Address - Phone:518-926-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129350104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker