Provider Demographics
NPI:1871770529
Name:PERRY, DONNA ELLEN (LMSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:ELLEN
Last Name:PERRY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BRIDGE ST.
Mailing Address - Street 2:CARTHAGE AREA BEHAVIORAL HEALTH CENTER
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-3928
Mailing Address - Country:US
Mailing Address - Phone:315-493-3300
Mailing Address - Fax:
Practice Address - Street 1:3 BRIDGE STREET
Practice Address - Street 2:CARTHAGE AREA BEHAVIORAL HEALTH CENTER
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-3928
Practice Address - Country:US
Practice Address - Phone:315-493-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069909-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker