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NPI Code Detail

MEDICARE: KAMI ANNETTE PEREZ LCSW, LCAS

MEDICARE: KAMI ANNETTE PEREZ LCSW, LCAS
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLCAS-22914NC
21041C0700XClinical Social WorkerP010561NC
31041C0700XClinical Social WorkerC011666NC

General Provider Information

NPI Number : 1114479839
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMI ANNETTE PEREZ LCSW, LCAS
Provider Business Mailing Address
First Line : 3505 VILLAGE DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-4513
Country : US
Telephone Number : 910-615-3737
Fax Number :
Provider Business Practice Location Address
First Line : 3505 VILLAGE DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-4513
Country : US
Telephone Number : 910-615-3737
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2016
Last Update Date : 09/29/2020

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