MEDICARE: CORRENE PERRY CPSS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	2025-14724-01	NC

General Provider Information

NPI Number	:	1770453466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORRENE PERRY CPSS

Provider Business Mailing Address
First Line	:	350 CALLANDALE LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-9803
Country	:	US
Telephone Number	:	919-519-0170
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 N DUKE ST STE 18
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-1769
Country	:	US
Telephone Number	:	919-519-0170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2025
Last Update Date	:	11/18/2025

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