Provider Demographics
NPI:1194323980
Name:PERKINS, JAMES P JR (CMHA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:PERKINS
Suffix:JR
Gender:M
Credentials:CMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 TRAEBERT CIR APT 210
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-5813
Mailing Address - Country:US
Mailing Address - Phone:919-306-0268
Mailing Address - Fax:
Practice Address - Street 1:4205 WAKE FOREST RD STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6246
Practice Address - Country:US
Practice Address - Phone:919-306-0268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health