Provider Demographics
NPI:1801090105
Name:PERKINS, STEPHANIE DAWN (MHP)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:DAWN
Last Name:PERKINS
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 W POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:IL
Mailing Address - Zip Code:62806-1037
Mailing Address - Country:US
Mailing Address - Phone:618-445-2738
Mailing Address - Fax:
Practice Address - Street 1:130 W 7TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:IL
Practice Address - Zip Code:62863-1439
Practice Address - Country:US
Practice Address - Phone:618-263-3873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker