Provider Demographics
NPI:1497882260
Name:PERLA, JENNIFER L (LPC)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:L
Last Name:PERLA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8399 APPLE BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1192
Mailing Address - Country:US
Mailing Address - Phone:214-649-4959
Mailing Address - Fax:866-627-5124
Practice Address - Street 1:15851 DALLAS PKWY STE 600
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-6030
Practice Address - Country:US
Practice Address - Phone:214-649-4959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019117101YM0800X
TX18968101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health