Provider Demographics
NPI:1124487756
Name:PERKINS, CATHRYN (LPC)
Entity type:Individual
Prefix:
First Name:CATHRYN
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 NE HIGHWAY 20 STE 610
Mailing Address - Street 2:C/O NLA #217
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6403
Mailing Address - Country:US
Mailing Address - Phone:541-617-8989
Mailing Address - Fax:
Practice Address - Street 1:2660 NE HIGHWAY 20 STE 610
Practice Address - Street 2:C/O NLA #217
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6403
Practice Address - Country:US
Practice Address - Phone:541-617-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional