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General NPI Number Information
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NPI Number | 1245828623
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Entity Type | Individual
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Provider Name | ANNETTE CALVARIO PERALES PHD, LMHC, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 01/01/2021
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 10009 NE 130TH LN APT 3
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City | KIRKLAND
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State | WA
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Zip | 98034-9021
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Country | US
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Telephone | 269-230-0940
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Fax |
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Provider Business Mailing Address
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Address Line | 10009 NE 130TH LN APT 3
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City | KIRKLAND
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State | WA
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Zip | 98034-9021
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Country | US
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Telephone | 269-230-0940
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401017833
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401017833
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License Number State | MI
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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 | LH61157091
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License Number State | WA
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