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NPI Code Detail

MEDICARE: MAYRA CECILIA PEREZ MSW

MEDICARE: MAYRA CECILIA PEREZ MSW
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
1104100000XSocial WorkerSWB-2023-0012NM
2101Y00000XCounselorX11826NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366109001
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYRA CECILIA PEREZ MSW
Provider Business Mailing Address
First Line : 148 55TH ST SW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87121-2306
Country : US
Telephone Number : 505-917-1648
Fax Number :
Provider Business Practice Location Address
First Line : 1317 ISLETA BLVD SW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87105-4035
Country : US
Telephone Number : 505-917-1648
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2021
Last Update Date : 03/10/2026

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Directions to “ MAYRA CECILIA PEREZ MSW” Practice Location

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