Provider Demographics
NPI:1396967014
Name:PEREZ, JULISSA H (LCSW)
Entity type:Individual
Prefix:MISS
First Name:JULISSA
Middle Name:H
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 BRIGHTON ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6701
Mailing Address - Country:US
Mailing Address - Phone:908-327-5445
Mailing Address - Fax:
Practice Address - Street 1:17 SENIOR ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-8534
Practice Address - Country:US
Practice Address - Phone:732-932-7884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker