Healthcare Provider Details

I. General information

NPI: 1285198432
Provider Name (Legal Business Name): PERRY PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 MAIN ST FL 2
HOLDEN MA
01520-1222
US

IV. Provider business mailing address

PO BOX 52
HOLDEN MA
01520-0052
US

V. Phone/Fax

Practice location:
  • Phone: 508-241-4248
  • Fax: 978-560-0096
Mailing address:
  • Phone: 508-241-4248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERICA PERRY
Title or Position: PSYCHIATRIC CNP/ OWNER
Credential: PSYCHIATRIC CNP
Phone: 508-733-7398