Provider Demographics
NPI:1497142335
Name:PEREZ, AMY (LMHC)
Entity Type:Individual
Prefix:
First Name:AMY
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 1:2001 E 2ND AVE UNIT 5
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-5210
Mailing Address - Country:US
Mailing Address - Phone:813-294-2238
Mailing Address - Fax:
Practice Address - Street 1:2001 E 2ND AVE UNIT 5
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605-5210
Practice Address - Country:US
Practice Address - Phone:813-294-2238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health