MEDICARE: MS. LILYVETTE PEREZ LMHC,LPC,NCC,BC-TMH

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	101YM0800X	Mental Health Counselor	7005	MA
2	101YP2500X	Professional Counselor	90269	TX
3	101YP2500X	Professional Counselor	5924	CT

General Provider Information

NPI Number	:	1104965912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LILYVETTE PEREZ LMHC,LPC,NCC,BC-TMH

Provider Business Mailing Address
First Line	:	2186 JACKSON KELLER RD STE 2280
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-2723
Country	:	US
Telephone Number	:	774-231-8056
Fax Number	:

Provider Business Practice Location Address
First Line	:	3310 OAKWELL CT APT 18304
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-3984
Country	:	US
Telephone Number	:	210-867-4493
Fax Number	:

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	10/24/2023

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