Provider Demographics
NPI:1659709954
Name:PEREZ, FELIX ALEXANDER (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:ALEXANDER
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E ALLEN ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-4189
Mailing Address - Country:US
Mailing Address - Phone:215-554-1191
Mailing Address - Fax:
Practice Address - Street 1:112 E ALLEN ST UNIT 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-4189
Practice Address - Country:US
Practice Address - Phone:215-554-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW017867104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty