Provider Demographics
NPI:1902911480
Name:PEREZ, NOELIA (LCSW)
Entity Type:Individual
Prefix:
First Name:NOELIA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20B LAKEVIEW AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-3117
Mailing Address - Country:US
Mailing Address - Phone:473-855-6697
Mailing Address - Fax:212-937-3155
Practice Address - Street 1:48 BURD ST STE 306
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3257
Practice Address - Country:US
Practice Address - Phone:914-330-5662
Practice Address - Fax:315-620-8426
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 1041S0200X
NY067030104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool