Provider Demographics
NPI:1144705815
Name:PERRY WELLNESS COUNSELING, PLLC
Entity type:Organization
Organization Name:PERRY WELLNESS COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:D
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MA LCMHCA NCC
Authorized Official - Phone:980-270-1939
Mailing Address - Street 1:PO BOX 25923
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28229-5923
Mailing Address - Country:US
Mailing Address - Phone:980-270-1939
Mailing Address - Fax:980-270-4557
Practice Address - Street 1:6733 FAIRVIEW RD STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3652
Practice Address - Country:US
Practice Address - Phone:980-270-1939
Practice Address - Fax:980-270-4557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health