Provider Demographics
NPI:1356571327
Name:PEREZ, DAVID (LMHC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 NW 28TH LN
Mailing Address - Street 2:SUITE 6
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7432
Mailing Address - Country:US
Mailing Address - Phone:352-316-6796
Mailing Address - Fax:352-375-1003
Practice Address - Street 1:4131 NW 28TH LN
Practice Address - Street 2:SUITE 6
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7432
Practice Address - Country:US
Practice Address - Phone:352-316-6796
Practice Address - Fax:352-375-1003
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2012-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6187101YM0800X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)