Provider Demographics
NPI:1861509291
Name:PERRITT, KATHLEEN (LCSW, LAC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:PERRITT
Suffix:
Gender:F
Credentials:LCSW, LAC
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 69004
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71306-9004
Mailing Address - Country:US
Mailing Address - Phone:318-357-3300
Mailing Address - Fax:318-357-3326
Practice Address - Street 1:740 KEYSER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6037
Practice Address - Country:US
Practice Address - Phone:318-357-3300
Practice Address - Fax:318-357-3326
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA845101YA0400X
LA83191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)