Provider Demographics
NPI:1659168706
Name:PERRITT, CHARLES J (LPC-A, LCDCI)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:J
Last Name:PERRITT
Suffix:
Gender:
Credentials:LPC-A, LCDCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 LINDY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND SALINE
Mailing Address - State:TX
Mailing Address - Zip Code:75140-1089
Mailing Address - Country:US
Mailing Address - Phone:903-368-4257
Mailing Address - Fax:
Practice Address - Street 1:801 LINDY DR
Practice Address - Street 2:
Practice Address - City:GRAND SALINE
Practice Address - State:TX
Practice Address - Zip Code:75140-1089
Practice Address - Country:US
Practice Address - Phone:903-368-4257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94990101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health