Provider Demographics
NPI:1437166089
Name:PERAINO, JOSEPH M (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:PERAINO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9090 RIDGELINE BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2505
Mailing Address - Country:US
Mailing Address - Phone:713-666-1743
Mailing Address - Fax:281-496-4648
Practice Address - Street 1:9090 RIDGELINE BLVD
Practice Address - Street 2:STE 220
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2505
Practice Address - Country:US
Practice Address - Phone:713-666-1743
Practice Address - Fax:281-496-4648
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO3396103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00DX50Medicare UPIN