Anquenette M Perkins, PHD, LCSW, PMH-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149027583 Issued in IL

Practice address

4801 W Peterson Ave Ste 612
Chicago, IL 60646-5728

Phone

(773) 808-7077

NPI assigned

Dec 8, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1821694548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 W WASHINGTON BLVD APT F2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE STE 612",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465728",
            "telephone_number": "773-808-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "ANQUENETTE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PHD, LCSW, PMH-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150014856",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSING",
            "identifier": "150014856",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Periodontics and Implant Dentistry LLC
• Periodontics LTD.
• Angela Perizes, RD,LDN
• Eric Perkey, MD
• Perkins Enterprise Limited Liability Company
• Ashley Perkins, MS, CCC-SLP
• Brytrina Perkins, LCSW, CADC
• David L Perkins, M.D
• Henry James Perkins, PH.D.
• Imani Perkins

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.