Provider Demographics
NPI:1114631926
Name:AFFIRMED FAMILY PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:AFFIRMED FAMILY PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:608-628-0834
Mailing Address - Street 1:442 TOEPFER AVE
Mailing Address - Street 2:C/O BARB PERKINS
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-1660
Mailing Address - Country:US
Mailing Address - Phone:608-628-0834
Mailing Address - Fax:608-442-5558
Practice Address - Street 1:2961 YARMOUTH GREENWAY DR STE 2
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5809
Practice Address - Country:US
Practice Address - Phone:608-628-0834
Practice Address - Fax:608-442-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty