Provider Demographics
NPI:1972328862
Name:PERL, LAUREL KATHRYN (LMHC)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:KATHRYN
Last Name:PERL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 VERNAL RD
Mailing Address - Street 2:
Mailing Address - City:ATTICA
Mailing Address - State:NY
Mailing Address - Zip Code:14011-9321
Mailing Address - Country:US
Mailing Address - Phone:585-356-7653
Mailing Address - Fax:
Practice Address - Street 1:4520 VERNAL RD
Practice Address - Street 2:
Practice Address - City:ATTICA
Practice Address - State:NY
Practice Address - Zip Code:14011-9321
Practice Address - Country:US
Practice Address - Phone:585-356-7653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013554101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health