Provider Demographics
NPI:1427337054
Name:PERAINO, JULIE ANNE (LMSW)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNE
Last Name:PERAINO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16207 APPLEBY LN
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-2365
Mailing Address - Country:US
Mailing Address - Phone:734-420-3995
Mailing Address - Fax:
Practice Address - Street 1:705 S MAIN ST
Practice Address - Street 2:SUITE 280
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2089
Practice Address - Country:US
Practice Address - Phone:734-454-3560
Practice Address - Fax:734-454-3570
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-13
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010907841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical