Statisha L Perry

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2300 W Park Place Blvd Ste 135
Suite 135
Stone Mountain, GA 30087-3561

Phone

(678) 330-1400

NPI assigned

Dec 3, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Potter'S House Family and Children Treatment Center

  • Adolescent and Children Mental Health Clinic/Center
  • Stone Mountain, GA
  • NPI 1326230020
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1275003337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 BRADLEY DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300396542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W PARK PLACE BLVD STE 135",
            "address_2": "SUITE 135",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873561",
            "telephone_number": "678-330-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "STATISHA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Peeler, FNP-C
• Per Diem Healthcare, Inc.
• Perimeter Transportation Services, LLC
• Johana Andrea Perrine, M.D.
• Audrey Perry
• Personalized Home Health Care, LLC
• Kathy Petrie, ANP
• Noreen O'Connor Peyatt
• Daniel Pham, DPT
• Mia Phan

• Addiction (Substance Use Disorder) Counselor in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.