MEDICARE: KEVIN RAFAEL PEREZ BAEZ LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC020016	PA

General Provider Information

NPI Number	:	1346197480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN RAFAEL PEREZ BAEZ LPC

Provider Business Mailing Address
First Line	:	PO BOX 116
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-0116
Country	:	US
Telephone Number	:	215-882-4374
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 E FRONT ST
Second Line	:
City	:	MEDIA
State	:	PA
Zip	:	19063-2911
Country	:	US
Telephone Number	:	215-882-4374
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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