Healthcare Provider Details

I. General information

NPI: 1669117719
Provider Name (Legal Business Name): ALLISON CATHLEEN PERKINS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 KANAWHA BLVD E
CHARLESTON WV
25301-2403
US

IV. Provider business mailing address

1116 KANAWHA BLVD E
CHARLESTON WV
25301-2403
US

V. Phone/Fax

Practice location:
  • Phone: 304-346-9689
  • Fax:
Mailing address:
  • Phone: 304-346-9689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2976
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: