Jenna Perusek, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

14219 Issued in NC

Practice address

108 Blythe Mill Rd
Waxhaw, NC 28173-7696

Phone

(704) 618-5370

NPI assigned

Aug 13, 2018

Last updated

Nov 24, 2021By the provider in NPPES

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

State licenses

Practice roles

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

• Alliance Clinical Counseling, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waxhaw, NC
  • NPI 1942887989
  NPD Authorized official
• Southeast Child & Family Guidance, PLLC

  • Mental Health Counselor
  • Waxhaw, NC
  • NPI 1356629273
  NPD (past)

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1891274510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BLYTHE MILL RD",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737696",
            "telephone_number": "704-618-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 BLYTHE MILL RD",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737696",
            "telephone_number": "704-618-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERUSEK",
        "first_name": "JENNA",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14219",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A14219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Pelletier
• Robert S Pennello Sr., LCMHCS
• Jennifer Peoples, RPH
• Constance Elaine Perkins, LCSW
• Danielle Perugini, MOT, OTRL
• Kimberly D Peterson, B.S. OTR/L
• Ryan William Petronis
• Alexandra M Philpott
• Phoenix House Child Agency
• Phoenix House Inc.

• Mental Health Counselor in Waxhaw, NC
• Providers in Waxhaw, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.