Provider Demographics
NPI:1649580580
Name:PEREZ, CAMILLE D (LMHC)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:D
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 1:523 HICKORY CT
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-1438
Mailing Address - Country:US
Mailing Address - Phone:305-510-7940
Mailing Address - Fax:407-737-7997
Practice Address - Street 1:630 N SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3330
Practice Address - Country:US
Practice Address - Phone:407-737-4007
Practice Address - Fax:407-737-7997
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10045101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health