Provider Demographics
NPI:1568609899
Name:PERRY, WILLIAM C (MS, LMFT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:C
Last Name:PERRY
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 E THOUSAND OAKS BLVD
Mailing Address - Street 2:SUITE 251
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3626
Mailing Address - Country:US
Mailing Address - Phone:805-497-3315
Mailing Address - Fax:
Practice Address - Street 1:3625 E THOUSAND OAKS BLVD
Practice Address - Street 2:SUITE 251
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3626
Practice Address - Country:US
Practice Address - Phone:805-497-3315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 31552106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist