Provider Demographics
NPI:1346689601
Name:PERALES, NINA ANGEL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:ANGEL
Last Name:PERALES
Suffix:
Gender:F
Credentials:LCSW
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Other - First Name:
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Mailing Address - Street 1:314 E HIGHLAND MALL BLVD
Mailing Address - Street 2:STE 301
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3735
Mailing Address - Country:US
Mailing Address - Phone:512-444-9922
Mailing Address - Fax:512-444-9926
Practice Address - Street 1:314 E HIGHLAND MALL BLVD
Practice Address - Street 2:STE 301
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3735
Practice Address - Country:US
Practice Address - Phone:512-444-9922
Practice Address - Fax:512-444-9926
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX544201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical