Provider Demographics
NPI:1629056098
Name:PERRY, MARION (LCDP LMHC LPC)
Entity Type:Individual
Prefix:MS
First Name:MARION
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:LCDP LMHC LPC
Other - Prefix:
Other - First Name:MARION
Other - Middle Name:
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:146 ANOKA ST
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806
Mailing Address - Country:US
Mailing Address - Phone:508-336-1113
Mailing Address - Fax:508-336-3402
Practice Address - Street 1:750 W US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-8115
Practice Address - Country:US
Practice Address - Phone:828-837-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4204101YM0800X
RIMHC00067101YM0800X
NC10135101YP2500X
RILCDP00058101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
62-01839OtherUBH
RI2311-2OtherBLUE CROSS
RIMJ25549Medicaid
MA1037130OtherBEACON
406491OtherBLUE CHIP
1037130OtherBEACON
MALM1061OtherBLUE CROSS BLUE SHIELD
259828OtherCOMPSYCH