Provider Demographics
NPI:1770958753
Name:PEREZ, SILVIO RICHARD (MS SW)
Entity type:Individual
Prefix:
First Name:SILVIO
Middle Name:RICHARD
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MS SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 WEST 900 NORTH
Mailing Address - Street 2:
Mailing Address - City:LAPORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350
Mailing Address - Country:US
Mailing Address - Phone:219-242-1221
Mailing Address - Fax:
Practice Address - Street 1:424 PERRY ST
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3200
Practice Address - Country:US
Practice Address - Phone:219-809-0333
Practice Address - Fax:219-809-0334
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical