Provider Demographics
NPI:1447792437
Name:PERUTO, MARGUERITE (LMHC)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:PERUTO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ROCK STREET
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809
Mailing Address - Country:US
Mailing Address - Phone:401-297-1001
Mailing Address - Fax:
Practice Address - Street 1:10 WARDWELL STREET
Practice Address - Street 2:STUDIO #4
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809
Practice Address - Country:US
Practice Address - Phone:401-297-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health