Provider Demographics
NPI:1629704325
Name:PERKINS, SELBY ANNE (MA, NCC, APC, MFA)
Entity Type:Individual
Prefix:
First Name:SELBY
Middle Name:ANNE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:MA, NCC, APC, MFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 MCLENDON AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-1758
Mailing Address - Country:US
Mailing Address - Phone:918-949-1295
Mailing Address - Fax:
Practice Address - Street 1:659 AUBURN AVE NE APT 228
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1980
Practice Address - Country:US
Practice Address - Phone:918-949-1295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty