Provider Demographics
NPI:1124572300
Name:PERKINS, ADAM (LCSW)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:PERKINS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GETCHELL ST # 16
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-2206
Mailing Address - Country:US
Mailing Address - Phone:207-659-1857
Mailing Address - Fax:
Practice Address - Street 1:760 UNION ST
Practice Address - Street 2:SUITE A
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3125
Practice Address - Country:US
Practice Address - Phone:207-989-2946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC176101041C0700X
MEMC162011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical