Provider Demographics
NPI:1992307748
Name:PERMUT, TESSA J (LPC)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:J
Last Name:PERMUT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 E BELLEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80121-1406
Mailing Address - Country:US
Mailing Address - Phone:303-594-4983
Mailing Address - Fax:
Practice Address - Street 1:911 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4141
Practice Address - Country:US
Practice Address - Phone:919-299-2253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-27610101YA0400X
COADDC.0000012101YA0400X
NC17196101YM0800X
COLPCC.0018646101YM0800X
COLPC.0019598101YM0800X
NCA17196101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)