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General NPI Number Information
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NPI Number | 1417331158
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Entity Type | Individual
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Provider Name | LISA LYNN PERKINS MA, LSW
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Gender | Female
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 352 MANSION ST
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City | HAMLIN
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State | WV
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Zip | 25523-1422
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Country | US
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Telephone | 304-824-4506
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 JEFFERSON AVE
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City | HUNTINGTON
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State | WV
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Zip | 25704-2428
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Country | US
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Telephone | 304-416-2256
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | AP000943706
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License Number State | WV
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