Provider Demographics
NPI:1811792112
Name:PERRY, STEPHANIE (BS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:PERRY
Suffix:
Gender:
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 LYONS AVE
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1148
Mailing Address - Country:US
Mailing Address - Phone:606-225-3920
Mailing Address - Fax:
Practice Address - Street 1:7351 US ROUTE 60
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-9605
Practice Address - Country:US
Practice Address - Phone:859-300-1802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker