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Contact Information

ETHAN PERRY, LMHC, CASAC
1133 ROUTE 55
2ND FLOOR
LAGRANGEVILLE, NY12540-5051
 Phone: 845-204-3436
 Fax: 845-298-8000
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for ETHAN PERRY · (Male)

NPI # 1124432752
Status Active
Credentials LMHC, CASAC
Entity Individual
Enumeration date 06/11/2014
Last updated 08/02/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 18 004757
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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