Provider Demographics
NPI:1154698140
Name:PERRY, NOCHIA DENISE (MA, LPC, CSAC, ICS)
Entity type:Individual
Prefix:MS
First Name:NOCHIA
Middle Name:DENISE
Last Name:PERRY
Suffix:
Gender:F
Credentials:MA, LPC, CSAC, ICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 N DR MARTIN LUTHER KING DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-3639
Mailing Address - Country:US
Mailing Address - Phone:414-347-1774
Mailing Address - Fax:414-347-0148
Practice Address - Street 1:1849 N. DR. MARTIN LUTHER KING DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212
Practice Address - Country:US
Practice Address - Phone:414-347-1774
Practice Address - Fax:414-347-0148
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-19
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15666-132101YA0400X
WI5243-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)