Provider Demographics
NPI:1114575768
Name:PERKINS, REX BEACH III (LICSW)
Entity Type:Individual
Prefix:MR
First Name:REX
Middle Name:BEACH
Last Name:PERKINS
Suffix:III
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 LURLEEN B WALLACE BLVD S
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2219
Mailing Address - Country:US
Mailing Address - Phone:205-861-0317
Mailing Address - Fax:
Practice Address - Street 1:1050 LURLEEN B WALLACE BLVD S
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2219
Practice Address - Country:US
Practice Address - Phone:205-861-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3951C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical