Provider Demographics
NPI:1821388257
Name:PEREZ, YVONNE MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:MARIE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:YVONNE
Other - Middle Name:MARIE
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:700 NEW BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5542
Mailing Address - Country:US
Mailing Address - Phone:512-262-7260
Mailing Address - Fax:512-262-7260
Practice Address - Street 1:102 WHITETAIL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-9739
Practice Address - Country:US
Practice Address - Phone:512-395-5458
Practice Address - Fax:512-395-5458
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16593101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX16593OtherLPC
NC28150OtherNATIONAL CERTIFIED COUNSELOR