Provider Demographics
NPI:1912344599
Name:PARRY, TODD C (LCSW)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:C
Last Name:PARRY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 AVE. F
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89301
Mailing Address - Country:US
Mailing Address - Phone:775-289-6171
Mailing Address - Fax:
Practice Address - Street 1:1675 AVENUE F
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-3500
Practice Address - Country:US
Practice Address - Phone:775-289-6171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT354709-35021041C0700X
NV7462-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV7462-COtherBOARD OF EXAMINERS FOR SOCIAL WORKERS