Provider Demographics
NPI:1588807648
Name:PEREZ-FERNANDEZ, MARIA DE LA ALHAMBRA (LMHC, LPC,NCC, CCMHC)
Entity Type:Individual
Prefix:
First Name:MARIA DE LA ALHAMBRA
Middle Name:
Last Name:PEREZ-FERNANDEZ
Suffix:
Gender:F
Credentials:LMHC, LPC,NCC, CCMHC
Other - Prefix:
Other - First Name:MARIA DE LA ALHAMBRA
Other - Middle Name:
Other - Last Name:PEREZ-FERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC,LPC, NCC, CCMHC
Mailing Address - Street 1:111 MORGAN AVE APT 5031
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1137
Mailing Address - Country:US
Mailing Address - Phone:860-968-7169
Mailing Address - Fax:860-370-4109
Practice Address - Street 1:111 MORGAN AVE APT 5031
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1137
Practice Address - Country:US
Practice Address - Phone:860-968-7169
Practice Address - Fax:860-370-4109
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-19
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH30831101YM0800X
FLLMHC10527101YM0800X
NCNCC 258838101YM0800X
CTHYP0000564101YM0800X
CT003700101YM0800X
NCCCMHC 258838101YM0800X
NY007184101YM0800X
NMCTB-2023-0931101YM0800X
NJ37PC00973000101YM0800X
MALMHC7442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003149600Medicaid