| Kenneth Dewayne Perry, | |
|
112 N Liberty St, Jackson, TN 38301-6200 | |
| (731) 736-4400 | |
| Not Available |
| Full Name | Kenneth Dewayne Perry |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 112 N Liberty St, Jackson, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922770528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 8145 (Tennessee) | Primary |
| Entity Name | Positive Living Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336614130 PECOS PAC ID: 8224367370 Enrollment ID: O20190916000575 |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20221116002565 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Dewayne Perry, Po Box 746725, Atlanta, GA 30374-6725 Ph: (312) 733-9730 | Kenneth Dewayne Perry, 112 N Liberty St, Jackson, TN 38301-6200 Ph: (731) 736-4400 |
Glen Gaugh, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 24 Weatherford Sq, Jackson, TN 38305 Phone: 731-660-6730 | |
Sarah M Venable, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 112 N Liberty St, Jackson, TN 38301 Phone: 731-736-4400 | |
Glen Tilghman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 374 N Parkway Ste B4, Jackson, TN 38305 Phone: 731-300-5131 | |
Kathelene Marie White, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 109 E Lafayette St, Jackson, TN 38301 Phone: 901-930-7397 | |
Francine Owens, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 238 Summar Dr, Jackson, TN 38301 Phone: 731-935-8200 Fax: 731-935-8327 | |
James A Jones Iii, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 238 Summar Dr, Jackson, TN 38301 Phone: 731-935-8200 Fax: 731-935-8327 | |
Mrs. Alymarie Taylor Laird, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 33 Murray Guard Dr, Jackson, TN 38305 Phone: 731-300-2627 |