Provider Demographics
NPI:1033260187
Name:PERUGI, AMY LEIGH (LMSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LEIGH
Last Name:PERUGI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37772 CHARTER OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-4435
Mailing Address - Country:US
Mailing Address - Phone:734-674-4772
Mailing Address - Fax:
Practice Address - Street 1:37772 CHARTER OAKS BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-4435
Practice Address - Country:US
Practice Address - Phone:586-277-6192
Practice Address - Fax:586-948-8758
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010825581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical