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General NPI Number Information
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NPI Number | 1972670164
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Entity Type | Individual
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Provider Name | MILDRED MARY PERREAULT PHD LCSW PSW
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6169 DELTONA BLVD CASTIGNOLI COURT IV
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City | SPRING HILL
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State | FL
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Zip | 34606
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Country | US
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Telephone | 352-592-2828
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Fax | 352-666-0066
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Provider Business Mailing Address
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Address Line | 4059 WINDOTA AVE
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City | SPRING HILL
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State | FL
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Zip | 34606
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Country | US
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Telephone | 352-666-0066
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Fax | 352-666-0066
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSW661
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3529CT
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | PSW661
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3529CT
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License Number State | CT
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