Provider Demographics
NPI:1730510371
Name:PERKOVICH, JESSIE M (LPCC)
Entity type:Individual
Prefix:MRS
First Name:JESSIE
Middle Name:M
Last Name:PERKOVICH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792-2528
Mailing Address - Country:US
Mailing Address - Phone:218-749-2881
Mailing Address - Fax:
Practice Address - Street 1:3203 3RD AVE W
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-2406
Practice Address - Country:US
Practice Address - Phone:182-263-9237
Practice Address - Fax:218-262-3150
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN682101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health