Provider Demographics
NPI:1023031754
Name:BAEZ-PEREZ, GLADYS NORYS (LCSW)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:NORYS
Last Name:BAEZ-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:PO BOX 7723
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77387-7723
Mailing Address - Country:US
Mailing Address - Phone:832-816-7817
Mailing Address - Fax:936-549-2100
Practice Address - Street 1:2017 N FRAZIER ST
Practice Address - Street 2:F-1
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1233
Practice Address - Country:US
Practice Address - Phone:936-703-5246
Practice Address - Fax:936-549-2100
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26752104100000X
PR3550104100000X
FLSW 59021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker