Provider Demographics
NPI:1205636016
Name:PEREZ, RAQUEL (LPCC)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:PEREZ
Suffix:
Gender:
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 S DUDLEY ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-5201
Mailing Address - Country:US
Mailing Address - Phone:720-206-4888
Mailing Address - Fax:
Practice Address - Street 1:9150 W JEWELL AVE STE 105
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6469
Practice Address - Country:US
Practice Address - Phone:720-254-1571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0022045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional