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General NPI Number Information
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NPI Number | 1336854686
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Entity Type | Individual
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Provider Name | MICHALENE PERRY
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Gender | Female
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Dates
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Enumeration Date | 01/20/2023
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 63 BEAVERBROOK RD
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City | LINCOLN PARK
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State | NJ
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Zip | 07035-1440
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Country | US
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Telephone | 986-206-0414
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Fax | 406-794-0395
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Provider Business Mailing Address
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Address Line | 6103 BALL LOOP LOT 3
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City | BALL
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State | LA
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Zip | 71405-9416
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Country | US
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Telephone | 724-854-1057
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8171960
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC0022629
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C10309
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8763
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License Number State | LA
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