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General NPI Number Information
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NPI Number | 1649577529
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Entity Type | Individual
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Provider Name | MICHAEL STUART PERRY M.A., L.P.C., N.C.C.
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Gender | Male
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Dates
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Enumeration Date | 02/11/2011
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 220 WERNER WAY
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City | SENOIA
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State | GA
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Zip | 30276-3615
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Country | US
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Telephone | 678-371-4803
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Fax | 678-723-0936
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Provider Business Mailing Address
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Address Line | 805 GLYNN ST S STE 127#326
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-2077
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Country | US
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Telephone | 678-371-4803
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Fax | 678-723-0936
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC007125
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License Number State | GA
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