Provider Demographics
NPI:1538653241
Name:PERRY, ANNE MARIE (LPC-IT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:PERRY
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:RIDDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-IT
Mailing Address - Street 1:700 REGENT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-2634
Mailing Address - Country:US
Mailing Address - Phone:608-567-4465
Mailing Address - Fax:608-467-9004
Practice Address - Street 1:700 REGENT ST STE 300
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-2634
Practice Address - Country:US
Practice Address - Phone:608-567-4465
Practice Address - Fax:608-467-9004
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1538653241Medicaid