Provider Demographics
NPI:1871588152
Name:SMITH, PERRIN DUNLAP (LCSW)
Entity type:Individual
Prefix:MS
First Name:PERRIN
Middle Name:DUNLAP
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30952 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-3827
Mailing Address - Country:US
Mailing Address - Phone:302-381-4779
Mailing Address - Fax:302-424-7772
Practice Address - Street 1:115 N WALNUT ST
Practice Address - Street 2:SUITE C
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1447
Practice Address - Country:US
Practice Address - Phone:302-424-1322
Practice Address - Fax:302-424-7772
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00005911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
G00044Medicare ID - Type Unspecified