Healthcare Provider Details

I. General information

NPI: 1508269986
Provider Name (Legal Business Name): ANGELA A. PERKINSON MA,LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 HENRY ST STE 317
ALTON IL
62002-6326
US

IV. Provider business mailing address

902 W MAIN ST
WEST FRANKFORT IL
62896-2210
US

V. Phone/Fax

Practice location:
  • Phone: 618-374-0176
  • Fax:
Mailing address:
  • Phone: 618-326-2772
  • Fax: 618-937-1440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.011421
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: