Provider Demographics
NPI:1205041449
Name:PERKINS, ELEANOR BRIDGET (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:BRIDGET
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2190 S MASON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1637
Mailing Address - Country:US
Mailing Address - Phone:314-494-4942
Mailing Address - Fax:314-994-9555
Practice Address - Street 1:4 CAROLE LN
Practice Address - Street 2:
Practice Address - City:FRONTENAC
Practice Address - State:MO
Practice Address - Zip Code:63131-2539
Practice Address - Country:US
Practice Address - Phone:314-994-9555
Practice Address - Fax:314-994-9555
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006015518101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional