Provider Demographics
NPI:1225804917
Name:PERKINS, KRISTINA (LISW-CP)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-1295
Mailing Address - Country:US
Mailing Address - Phone:864-515-9922
Mailing Address - Fax:
Practice Address - Street 1:100 WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1295
Practice Address - Country:US
Practice Address - Phone:864-515-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC164471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical