MEDICARE: ROSENDA PEREZ LPC

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	82919	TX

General Provider Information

NPI Number	:	1346874351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSENDA PEREZ LPC

Provider Business Mailing Address
First Line	:	1130 BEACHVIEW ST STE 130
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3701
Country	:	US
Telephone Number	:	214-530-1342
Fax Number	:

Provider Business Practice Location Address
First Line	:	2815 BICKERS ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75212-1300
Country	:	US
Telephone Number	:	972-502-4198
Fax Number	:

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

Provider Enumeration Date	:	02/28/2020
Last Update Date	:	09/26/2023

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Directions to “ ROSENDA PEREZ LPC” Practice Location

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