Provider Demographics
NPI:1144402207
Name:PERKINS, VIRGINIA RYAN (LPC)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:RYAN
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:GINNY
Other - Middle Name:RYAN
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:5224 E 88TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2922
Mailing Address - Country:US
Mailing Address - Phone:918-494-3606
Mailing Address - Fax:
Practice Address - Street 1:4803 S LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-5154
Practice Address - Country:US
Practice Address - Phone:918-510-2204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4578101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional