Provider Demographics
NPI:1356526339
Name:PERRIN, LISSA WINSLOW (MSW)
Entity type:Individual
Prefix:MS
First Name:LISSA
Middle Name:WINSLOW
Last Name:PERRIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 S MAIN ST
Mailing Address - Street 2:CHELSEA COMMUNITY HOSPITAL,OUTPATIENT BEHAVIORAL HEALTH
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1383
Mailing Address - Country:US
Mailing Address - Phone:734-475-4040
Mailing Address - Fax:734-475-4031
Practice Address - Street 1:775 S MAIN ST
Practice Address - Street 2:CHELSEA COMMUNITY HOSPITAL,OUTPATIENT BEHAVIORAL HEALTH
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1383
Practice Address - Country:US
Practice Address - Phone:734-475-4040
Practice Address - Fax:734-475-4031
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010125511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical