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General NPI Number Information
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NPI Number | 1407782717
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Entity Type | Individual
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Provider Name | ROXANA PEREZ NIEVES LAC
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Gender | Female
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 408 BETHEL RD STE C-2
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2184
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Country | US
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Telephone | 609-788-0199
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Fax |
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Provider Business Mailing Address
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Address Line | 4326 HARBOR BEACH BLVD UNIT 835
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City | BRIGANTINE
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State | NJ
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Zip | 08203-8030
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Country | US
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Telephone |
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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 | 37AC00688900
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License Number State | NJ
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