Provider Demographics
NPI:1306992300
Name:PERRIER, KIM MARIE (MA, LPCC)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:MARIE
Last Name:PERRIER
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5968 SIERRA NEVADA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-1634
Mailing Address - Country:US
Mailing Address - Phone:505-231-2095
Mailing Address - Fax:
Practice Address - Street 1:1925 ASPEN DR
Practice Address - Street 2:SUITE 702 B
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5459
Practice Address - Country:US
Practice Address - Phone:505-231-2095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0137081101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional