Provider Demographics
NPI:1104094630
Name:PERKINS, CHRISTOPHER G (LCPC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:G
Last Name:PERKINS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:CHENOA
Mailing Address - State:IL
Mailing Address - Zip Code:61726-9389
Mailing Address - Country:US
Mailing Address - Phone:309-532-7559
Mailing Address - Fax:
Practice Address - Street 1:702 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-2814
Practice Address - Country:US
Practice Address - Phone:309-827-6026
Practice Address - Fax:309-829-0016
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.004814101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor