Provider Demographics
NPI:1295438760
Name:PERRY, FELISA M (LLPC)
Entity type:Individual
Prefix:
First Name:FELISA
Middle Name:M
Last Name:PERRY
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:FELISA
Other - Middle Name:M
Other - Last Name:KRAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 WEBB DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4689
Mailing Address - Country:US
Mailing Address - Phone:248-649-8050
Mailing Address - Fax:
Practice Address - Street 1:131 WEBB DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-4689
Practice Address - Country:US
Practice Address - Phone:248-649-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451010269101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health