Provider Demographics
NPI:1679803118
Name:PEREZ, NILDA LUZ (MSW, ACSW,ICRC/AODA)
Entity Type:Individual
Prefix:MS
First Name:NILDA
Middle Name:LUZ
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MSW, ACSW,ICRC/AODA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7078
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7078
Mailing Address - Country:US
Mailing Address - Phone:787-747-3781
Mailing Address - Fax:
Practice Address - Street 1:CARR 787 KM 5.2 BO. BEATRIZ
Practice Address - Street 2:B4 URB PAOLO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-747-3781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006101YA0400X
PR2317101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health