Provider Demographics
NPI:1154047744
Name:PERKINS, AUGUSTA (CDCA)
Entity type:Individual
Prefix:
First Name:AUGUSTA
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1969 E DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3508
Mailing Address - Country:US
Mailing Address - Phone:614-987-6103
Mailing Address - Fax:
Practice Address - Street 1:1969 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3508
Practice Address - Country:US
Practice Address - Phone:614-987-6103
Practice Address - Fax:614-987-6108
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.181781101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health