Provider Demographics
NPI:1629300934
Name:PERRINE, MICHELE (LMHC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:PERRINE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 JACKSON ST
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3068
Mailing Address - Country:US
Mailing Address - Phone:508-344-4294
Mailing Address - Fax:
Practice Address - Street 1:92 JACKSON ST
Practice Address - Street 2:SUITE 204A
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3068
Practice Address - Country:US
Practice Address - Phone:508-344-4294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7146101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health