Provider Demographics
NPI:1144505306
Name:PERFECT, JAYNE (LMHC/LIMHP)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:PERFECT
Suffix:
Gender:F
Credentials:LMHC/LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W BROADWAY STE 240
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-9028
Mailing Address - Country:US
Mailing Address - Phone:402-850-6052
Mailing Address - Fax:712-340-1610
Practice Address - Street 1:300 W BROADWAY STE 240
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-9028
Practice Address - Country:US
Practice Address - Phone:402-850-6052
Practice Address - Fax:712-340-1610
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2184101YM0800X
NE3365101YM0800X
IA078924101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025769200Medicaid