Provider Demographics
NPI:1285892810
Name:PERKINS, MANDY ELIZABETH (M ED, LMFT)
Entity type:Individual
Prefix:MS
First Name:MANDY
Middle Name:ELIZABETH
Last Name:PERKINS
Suffix:
Gender:F
Credentials:M ED, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-3541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-3541
Practice Address - Country:US
Practice Address - Phone:860-716-1833
Practice Address - Fax:860-432-1332
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health