Provider Demographics
NPI:1770665093
Name:PERKINS, SHARON K (LMSW, CAADC)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:K
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LMSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 EAGLE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-2287
Mailing Address - Country:US
Mailing Address - Phone:616-499-2163
Mailing Address - Fax:
Practice Address - Street 1:2185 EAGLE BLVD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-2287
Practice Address - Country:US
Practice Address - Phone:616-499-2163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010867931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical