Provider Demographics
NPI:1861621823
Name:PERKINS, LISA (PLCSW)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 FORT BRAGG RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4721
Mailing Address - Country:US
Mailing Address - Phone:910-424-2020
Mailing Address - Fax:910-424-8435
Practice Address - Street 1:2712 FORT BRAGG RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4721
Practice Address - Country:US
Practice Address - Phone:910-424-2020
Practice Address - Fax:910-424-8435
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0048861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical