Provider Demographics
NPI:1922612654
Name:GONZALEZ PEREZ, ELIDE (LCSWA)
Entity Type:Individual
Prefix:
First Name:ELIDE
Middle Name:
Last Name:GONZALEZ PEREZ
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 BROOKLYN AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-6410
Mailing Address - Country:US
Mailing Address - Phone:828-551-5284
Mailing Address - Fax:
Practice Address - Street 1:1100 RIDGEFIELD BLVD STE 190
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-6211
Practice Address - Country:US
Practice Address - Phone:828-670-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0147821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical