Individual
DR. EDWIN DEJ. PERRY JOSEPH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
44 WASHINGTON ST, MYSTIC, CT 06355-2839
(860) 415-6837
Mailing address
PO BOX 521, OLD MYSTIC, CT 06372-0521
(860) 415-6837
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3714
AK
101YP2500X
Professional Counselor
46.002377
CT
103TC1900X
Counseling Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
004144
CT
1041C0700X
Clinical Social Worker
ISW01491
RI
Other
Enumeration date
09/07/2005
Last updated
03/18/2014
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