Provider Demographics
NPI:1679771661
Name:PERKINS, KRISTINA M (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:M
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2601 W 4TH ST
Mailing Address - Street 2:PO BOX 2610
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-3309
Mailing Address - Country:US
Mailing Address - Phone:302-856-9578
Mailing Address - Fax:302-856-6297
Practice Address - Street 1:406 S BEDFORD ST
Practice Address - Street 2:SUITE 9
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-1850
Practice Address - Country:US
Practice Address - Phone:302-856-9578
Practice Address - Fax:302-856-6297
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00008781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical