Provider Demographics
NPI:1386143592
Name:PERKINS, KATHRYN (LMSW-AP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LMSW-AP
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9869 KINGSMAN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-3752
Mailing Address - Country:US
Mailing Address - Phone:469-904-8469
Mailing Address - Fax:
Practice Address - Street 1:9550 FOREST LN STE 748
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5905
Practice Address - Country:US
Practice Address - Phone:469-904-8469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-03
Last Update Date:2018-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58428104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker