Provider Demographics
NPI:1033462130
Name:SOLIS PEREZ, JERIBETH (LMHC)
Entity Type:Individual
Prefix:
First Name:JERIBETH
Middle Name:
Last Name:SOLIS PEREZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:YOLI
Other - Middle Name:JERIBETH
Other - Last Name:SOLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21711 SW 97TH CT
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1176
Mailing Address - Country:US
Mailing Address - Phone:786-626-8281
Mailing Address - Fax:
Practice Address - Street 1:7875 SW 104TH ST STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2642
Practice Address - Country:US
Practice Address - Phone:305-740-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18247101Y00000X, 101YA0400X, 101YM0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program