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General NPI Number Information
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NPI Number | 1154625101
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Entity Type | Individual
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Provider Name | CAROLINA ANNA PEREZ LPC, CADC-II
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Gender | Female
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 655 7TH ST BLDG 707
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City | WARNER ROBINS
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State | GA
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Zip | 31098-2227
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Country | US
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Telephone | 478-926-4035
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Fax |
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Provider Business Mailing Address
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Address Line | 655 7TH ST BLDG 707
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City | WARNER ROBINS
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State | GA
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Zip | 31098-2227
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Country | US
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Telephone | 478-926-4035
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1266
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1220
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4216
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 009908
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License Number State | GA
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