Provider Demographics
NPI:1538514625
Name:PERRY, CHARMAINE ROSEMARIE (MS, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CHARMAINE
Middle Name:ROSEMARIE
Last Name:PERRY
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PYTEL RUN
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-3169
Mailing Address - Country:US
Mailing Address - Phone:973-979-3220
Mailing Address - Fax:
Practice Address - Street 1:16 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3527
Practice Address - Country:US
Practice Address - Phone:908-272-2474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00214100101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health