Provider Demographics
NPI:1134013360
Name:PERINE, LASHA (M ED, ALC)
Entity type:Individual
Prefix:
First Name:LASHA
Middle Name:
Last Name:PERINE
Suffix:
Gender:F
Credentials:M ED, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 YOUNG POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3070
Mailing Address - Country:US
Mailing Address - Phone:251-769-6508
Mailing Address - Fax:
Practice Address - Street 1:335 KERSHAW INDUSTRIAL BLVD STE B
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-5553
Practice Address - Country:US
Practice Address - Phone:334-293-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04832101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health