Provider Demographics
NPI:1275161176
Name:PEREZ, VIRGINIA (LMHC)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 MONTROSS RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4743
Mailing Address - Country:US
Mailing Address - Phone:914-334-3018
Mailing Address - Fax:
Practice Address - Street 1:211 MONTROSS RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4743
Practice Address - Country:US
Practice Address - Phone:914-334-3018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010288-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health