Provider Demographics
NPI:1023173887
Name:PERRINE, JOSEE ANN (MFT LADC)
Entity type:Individual
Prefix:
First Name:JOSEE
Middle Name:ANN
Last Name:PERRINE
Suffix:
Gender:F
Credentials:MFT LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2874 N CARSON ST
Mailing Address - Street 2:STE 215
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0177
Mailing Address - Country:US
Mailing Address - Phone:775-885-7717
Mailing Address - Fax:775-283-0231
Practice Address - Street 1:2874 N CARSON ST
Practice Address - Street 2:STE 215
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0177
Practice Address - Country:US
Practice Address - Phone:775-885-7717
Practice Address - Fax:775-283-0231
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00158-L101YA0400X
NV0962106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507929Medicaid