Provider Demographics
NPI:1396424172
Name:PEREZ, DARELYS (LMHC, LMFT)
Entity type:Individual
Prefix:
First Name:DARELYS
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24700 SW 119TH PL
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:FL
Mailing Address - Zip Code:33032-3024
Mailing Address - Country:US
Mailing Address - Phone:786-269-7596
Mailing Address - Fax:
Practice Address - Street 1:24700 SW 119TH PL
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:FL
Practice Address - Zip Code:33032-3024
Practice Address - Country:US
Practice Address - Phone:786-269-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4710106H00000X
FLMH21919101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist