Provider Demographics
NPI:1487351151
Name:PERRY, WILLIAM (LMSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 RITTER DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-7577
Mailing Address - Country:US
Mailing Address - Phone:571-269-6269
Mailing Address - Fax:
Practice Address - Street 1:300 FOXCROFT AVE STE 100A
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-5341
Practice Address - Country:US
Practice Address - Phone:340-263-6776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0076111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical