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General NPI Number Information
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NPI Number | 1700355492
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Entity Type | Organization
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Legal Business Name | LISA J PERKINS PSYCHOTHERAPY
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Dates
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Enumeration Date | 11/25/2018
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Last Update Date | 01/01/2019
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Provider Practice Location Address
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Address Line | 411 ROUTE 6A BLDG 5 UNIT C
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City | YARMOUTH PORT
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State | MA
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Zip | 02675-1843
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Country | US
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Telephone | 774-212-5715
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Fax | 508-433-1871
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Provider Business Mailing Address
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Address Line | 5 GREENEEDLE LN
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City | DENNIS PORT
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State | MA
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Zip | 02639-1842
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Country | US
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Telephone | 774-212-5715
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Fax | 508-433-1871
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Authorized Official
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Title or Position | OWNER
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Name | LISA J PERKINS
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Credential | LICSW
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Telephone | 774-212-5715
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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 |
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License Number State |
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