Individual
MS. ANQUENETTE M PERKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LCSW, PMH-C
Contact information
Practice address
4801 W PETERSON AVE STE 612, CHICAGO, IL 60646-5728
(773) 808-7077
Mailing address
939 W WASHINGTON BLVD APT F2, CHICAGO, IL 60607-2263
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150014856
IL
1041C0700X
Clinical Social Worker
Primary
149027583
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150014856
LICENSING
IL
Enumeration date
12/08/2020
Last updated
12/30/2024
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