Provider Demographics
NPI:1568764439
Name:PERRY, CHARRISSE
Entity Type:Individual
Prefix:MS
First Name:CHARRISSE
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5606 GRAND TRAVERSE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-5400
Mailing Address - Country:US
Mailing Address - Phone:252-548-0737
Mailing Address - Fax:
Practice Address - Street 1:5606 GRAND TRAVERSE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-5400
Practice Address - Country:US
Practice Address - Phone:252-548-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health