Provider Demographics
NPI:1962786285
Name:PARRISH, KODY S (LISW)
Entity type:Individual
Prefix:
First Name:KODY
Middle Name:S
Last Name:PARRISH
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 MERIDIAN WAY
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7648
Mailing Address - Country:US
Mailing Address - Phone:614-392-8446
Mailing Address - Fax:
Practice Address - Street 1:670 MERIDIAN WAY STE 178
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-2303
Practice Address - Country:US
Practice Address - Phone:614-392-8446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1700235104100000X
OHI20023171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker