Provider Demographics
NPI:1851883961
Name:HEATHER D PEREZ LPC PLLC
Entity Type:Organization
Organization Name:HEATHER D PEREZ LPC PLLC
Other - Org Name:MINDFUL SOLUTIONS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:DAWN PEREZ
Authorized Official - Last Name:TROWBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:682-231-1456
Mailing Address - Street 1:6777 CAMP BOWIE BLVD STE 229
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-7157
Mailing Address - Country:US
Mailing Address - Phone:682-703-1311
Mailing Address - Fax:817-735-4688
Practice Address - Street 1:6777 CAMP BOWIE BLVD STE 229
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7157
Practice Address - Country:US
Practice Address - Phone:682-703-1311
Practice Address - Fax:817-735-4688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-04
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71867101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX371098001Medicaid
TX1396102356Medicaid