Provider Demographics
NPI:1689964157
Name:PERKINS, VERONICA (LCSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:SPANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1221 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-4014
Mailing Address - Country:US
Mailing Address - Phone:573-221-2111
Mailing Address - Fax:573-221-2123
Practice Address - Street 1:1221 MARKET ST
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-4014
Practice Address - Country:US
Practice Address - Phone:573-221-2111
Practice Address - Fax:673-221-2123
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050151421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical