Provider Demographics
NPI:1528402807
Name:PERKINS, TAMMY (BS, LAC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:BS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 N 29TH ST
Mailing Address - Street 2:#236 & 237
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1985
Mailing Address - Country:US
Mailing Address - Phone:406-860-4499
Mailing Address - Fax:406-206-4597
Practice Address - Street 1:208 N 29TH ST
Practice Address - Street 2:#236 & 237
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1985
Practice Address - Country:US
Practice Address - Phone:406-860-4499
Practice Address - Fax:406-206-4597
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1229101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT569E4B07D3Medicaid