Provider Demographics
NPI:1881909653
Name:PERRY, LAWRENCE (MS)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 N. MAIN ST.
Mailing Address - Street 2:CATHOLIC CHARITIES SOUTH
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301
Mailing Address - Country:US
Mailing Address - Phone:508-587-0815
Mailing Address - Fax:508-580-0837
Practice Address - Street 1:686 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2492
Practice Address - Country:US
Practice Address - Phone:508-587-0815
Practice Address - Fax:508-580-0837
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health