Provider Demographics
NPI:1003626052
Name:PERA, MARTHA CECILIA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:CECILIA
Last Name:PERA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9408 SW 50TH ST
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-4143
Mailing Address - Country:US
Mailing Address - Phone:954-448-5779
Mailing Address - Fax:
Practice Address - Street 1:2300 WESTON RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3248
Practice Address - Country:US
Practice Address - Phone:954-268-5438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23786101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health