Provider Demographics
NPI:1447992318
Name:PEREZ, JANNA MICHELLE (LPC)
Entity type:Individual
Prefix:
First Name:JANNA
Middle Name:MICHELLE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W TEXAS AVE APT 614
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-3263
Mailing Address - Country:US
Mailing Address - Phone:409-526-8156
Mailing Address - Fax:
Practice Address - Street 1:100 W TEXAS AVE APT 614
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-3263
Practice Address - Country:US
Practice Address - Phone:409-526-8156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75964101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty