Provider Demographics
NPI:1700221827
Name:PEREZ, HECTOR (LICSW)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 QUEEN ST
Mailing Address - Street 2:TEAM 3, OFFICE 3M
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-2473
Mailing Address - Country:US
Mailing Address - Phone:508-860-7930
Mailing Address - Fax:508-860-7989
Practice Address - Street 1:26 QUEEN ST
Practice Address - Street 2:TEAM 3, OFFICE 3M
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-2473
Practice Address - Country:US
Practice Address - Phone:508-860-7930
Practice Address - Fax:508-860-7989
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker