Provider Demographics
NPI:1760114516
Name:PERKINS, HEATHER R (LPC, LCMHCA, LCASA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LPC, LCMHCA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-0071
Mailing Address - Country:US
Mailing Address - Phone:910-899-6337
Mailing Address - Fax:
Practice Address - Street 1:108 BUCKHORN AVE
Practice Address - Street 2:
Practice Address - City:SURF CITY
Practice Address - State:NC
Practice Address - Zip Code:28445-1130
Practice Address - Country:US
Practice Address - Phone:910-899-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS27306101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)