Healthcare Provider Details

I. General information

NPI: 1245808419
Provider Name (Legal Business Name): CALEB JOHN EDWARD PERKINS MSW, LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST
DAYTON OH
45409-2711
US

IV. Provider business mailing address

1 WYOMING ST
DAYTON OH
45409-2711
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-8060
  • Fax:
Mailing address:
  • Phone: 937-208-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2608310
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: