Provider Demographics
NPI:1538694062
Name:PERRY, KAREN (MA, LPCA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:MA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11020 S TRYON ST STE 408
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-6662
Mailing Address - Country:US
Mailing Address - Phone:704-978-8181
Mailing Address - Fax:704-935-5493
Practice Address - Street 1:11020 S TRYON ST STE 408
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-6662
Practice Address - Country:US
Practice Address - Phone:704-978-8181
Practice Address - Fax:704-935-5493
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health