Provider Demographics
NPI:1467572453
Name:PERKINS, SANDRA SCOTT (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:SCOTT
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51272
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-1272
Mailing Address - Country:US
Mailing Address - Phone:806-374-5950
Mailing Address - Fax:806-358-4345
Practice Address - Street 1:4211 W INTERSTATE 40
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-6053
Practice Address - Country:US
Practice Address - Phone:806-374-5950
Practice Address - Fax:806-358-4345
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18145101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6198LCOtherBLUE CROSS BLUE SHEILD