Provider Demographics
NPI:1912597881
Name:PERRY, BRYAN (LMSW)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 TRAFALGAR DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-9794
Mailing Address - Country:US
Mailing Address - Phone:302-222-8727
Mailing Address - Fax:
Practice Address - Street 1:216 TRAFALGAR DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-9794
Practice Address - Country:US
Practice Address - Phone:302-313-6234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0010447104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker