Provider Demographics
NPI:1366740078
Name:S BARBARA PERRY LLC
Entity type:Organization
Organization Name:S BARBARA PERRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW-C
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:410-984-3362
Mailing Address - Street 1:25 W CHESAPEAKE AVE
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4820
Mailing Address - Country:US
Mailing Address - Phone:410-984-3362
Mailing Address - Fax:410-339-3475
Practice Address - Street 1:25 W CHESAPEAKE AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4820
Practice Address - Country:US
Practice Address - Phone:410-984-3362
Practice Address - Fax:410-339-3475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07087261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health