Provider Demographics
NPI:1699983213
Name:PERRY, SANDRA SPARROW (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SPARROW
Last Name:PERRY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 WEST ST
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-4851
Mailing Address - Country:US
Mailing Address - Phone:252-637-5687
Mailing Address - Fax:252-637-9526
Practice Address - Street 1:2557 CEDAR DELL LN
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-9113
Practice Address - Country:US
Practice Address - Phone:252-527-4409
Practice Address - Fax:252-527-4422
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist