Provider Demographics
NPI:1780442368
Name:PEREZ, KATHERINE DELFINA (LMSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:DELFINA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 W 189TH ST APT 5O
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-0416
Mailing Address - Country:US
Mailing Address - Phone:646-479-1607
Mailing Address - Fax:
Practice Address - Street 1:910 E 172ND ST FL 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-5802
Practice Address - Country:US
Practice Address - Phone:646-901-1489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119491104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker