Healthcare Provider Details

I. General information

NPI: 1972433241
Provider Name (Legal Business Name): SHELBY PERKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 JUNCTION RD STE 6500
MADISON WI
53717-2153
US

IV. Provider business mailing address

1010 E WASHINGTON AVE APT 713
MADISON WI
53703-4413
US

V. Phone/Fax

Practice location:
  • Phone: 608-531-0880
  • Fax:
Mailing address:
  • Phone: 608-616-5315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1223-228
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: