Provider Demographics
NPI:1790476844
Name:PERKUMAS, CHRISTINE LOUISE (PLADC, PLMHP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:PERKUMAS
Suffix:
Gender:F
Credentials:PLADC, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8998 L ST STE 110
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1400
Mailing Address - Country:US
Mailing Address - Phone:402-320-0785
Mailing Address - Fax:
Practice Address - Street 1:8998 L ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1486
Practice Address - Country:US
Practice Address - Phone:402-651-5404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13383101YM0800X
NEP-2013101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health