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General NPI Number Information
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NPI Number | 1114136488
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Entity Type | Individual
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Provider Name | LISA MCDERMOTT PEREZ LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 1825 FOREST HILL BLVD SUITE 204
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-8902
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Country | US
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Telephone | 561-792-7000
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Fax | 561-792-5599
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Provider Business Mailing Address
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Address Line | PO BOX 212979
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33421-2979
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Country | US
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Telephone | 561-792-7000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMHC 8490
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License Number State | FL
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