Provider Demographics
NPI:1083361372
Name:PERKINS, KASEEM (CASAC-T)
Entity Type:Individual
Prefix:
First Name:KASEEM
Middle Name:
Last Name:PERKINS
Suffix:
Gender:M
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 KINGSBOROUGH 6TH WALK APT 5D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3840
Mailing Address - Country:US
Mailing Address - Phone:347-372-8395
Mailing Address - Fax:212-966-7160
Practice Address - Street 1:233 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-4051
Practice Address - Country:US
Practice Address - Phone:212-431-6177
Practice Address - Fax:212-966-7160
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31486101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)