Provider Demographics
NPI:1083171136
Name:BERTL, YESENIA PEREZ (LMFT)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:PEREZ
Last Name:BERTL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9347 KINGSFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-5044
Mailing Address - Country:US
Mailing Address - Phone:281-814-6423
Mailing Address - Fax:
Practice Address - Street 1:11200 BROADWAY ST STE 2743
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9787
Practice Address - Country:US
Practice Address - Phone:281-937-4139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty