Provider Demographics
NPI:1285720078
Name:PERKINS, DIAN S (LCSW)
Entity type:Individual
Prefix:
First Name:DIAN
Middle Name:S
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-1529
Mailing Address - Country:US
Mailing Address - Phone:412-429-4061
Mailing Address - Fax:412-429-4063
Practice Address - Street 1:111 HAZEL LANE
Practice Address - Street 2:SUITE 300
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143
Practice Address - Country:US
Practice Address - Phone:412-749-7330
Practice Address - Fax:412-749-7339
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW003396L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA076596GZUMedicare PIN