Perry, Mia G

Perry, Mia G is an individual health care provider with primary practice located at 1236 Paris Pike , Georgetown KY 40324-9701. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Perry, Mia G can be contacted via phone (502) 370-7229.

Contact Information

Primary practice address
1236 Paris Pike Georgetown KY 40324-9701
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 5032 Kentucky

Profile Details

NPI number 1891047429
LBN Legal business name Perry, Mia G
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2012
Last updated Jan 12th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891047429 NPPES
Kentucky MEDICAID 1790731081

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