Provider Demographics
NPI:1689705048
Name:PARSHALL, MERSHONA (LCSW, LISW, ATR-BC)
Entity type:Individual
Prefix:MS
First Name:MERSHONA
Middle Name:
Last Name:PARSHALL
Suffix:
Gender:F
Credentials:LCSW, LISW, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 SANGRE DE CRISTO
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-9402
Mailing Address - Country:US
Mailing Address - Phone:440-786-9838
Mailing Address - Fax:
Practice Address - Street 1:144 SANGRE DE CRISTO
Practice Address - Street 2:
Practice Address - City:CEDAR CREST
Practice Address - State:NM
Practice Address - Zip Code:87008-9402
Practice Address - Country:US
Practice Address - Phone:440-786-9838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00093971041C0700X
OH11047221700000X
AZ168081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty