Provider Demographics
NPI:1790084192
Name:PEREZ, CARRIE SERJEANT (MSW, LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:SERJEANT
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MSW, LCSW, BCD
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:DIANE
Other - Last Name:SERJEANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW, BCD
Mailing Address - Street 1:2803 MEDICAL CAMPUS DRIVE
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27531
Mailing Address - Country:US
Mailing Address - Phone:919-722-1883
Mailing Address - Fax:
Practice Address - Street 1:141 PARKER ST STE 306
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-2180
Practice Address - Country:US
Practice Address - Phone:866-991-2103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0071471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical