Provider Demographics
NPI:1083642292
Name:PEREZ, EVELYN MARIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:MARIA
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 1:5599 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3406
Mailing Address - Country:US
Mailing Address - Phone:954-229-7755
Mailing Address - Fax:954-229-7643
Practice Address - Street 1:5599 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3406
Practice Address - Country:US
Practice Address - Phone:954-229-7755
Practice Address - Fax:954-229-7643
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003842A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical