Provider Demographics
NPI:1255856696
Name:PEREZ COUNSELING SERVICES, PC
Entity Type:Organization
Organization Name:PEREZ COUNSELING SERVICES, PC
Other - Org Name:PEREZ COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LIMHP
Authorized Official - Prefix:
Authorized Official - First Name:ODALYS
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTAYA PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LIMHP
Authorized Official - Phone:402-460-7963
Mailing Address - Street 1:1941 S. 42ND ST.
Mailing Address - Street 2:416-N
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2939
Mailing Address - Country:US
Mailing Address - Phone:402-460-7963
Mailing Address - Fax:402-763-2894
Practice Address - Street 1:1941 S 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2939
Practice Address - Country:US
Practice Address - Phone:402-460-7963
Practice Address - Fax:402-763-2894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1096101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty