Provider Demographics
NPI:1366015661
Name:PERKINS, AUTUMN (RBT)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 ADDMORE LN LOT 28
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129-9173
Mailing Address - Country:US
Mailing Address - Phone:502-409-1886
Mailing Address - Fax:
Practice Address - Street 1:2916 PEACH BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-8380
Practice Address - Country:US
Practice Address - Phone:812-202-6144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-21-176793106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician