Provider Demographics
NPI:1699266486
Name:PERKO, ERIN E (LISW-S)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:PERKO
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 POMEROY ROAD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701
Mailing Address - Country:US
Mailing Address - Phone:828-776-1412
Mailing Address - Fax:740-773-4750
Practice Address - Street 1:53 POMEROY ROAD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701
Practice Address - Country:US
Practice Address - Phone:740-592-3091
Practice Address - Fax:740-773-3985
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2864002Medicaid
OH2314525Medicaid