Provider Demographics
NPI:1437791142
Name:PEREZ, VICKI (LPC)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:PEREZ
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 RICHMOND CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5503
Mailing Address - Country:US
Mailing Address - Phone:732-289-5125
Mailing Address - Fax:
Practice Address - Street 1:380 FOOTHILL RD
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2255
Practice Address - Country:US
Practice Address - Phone:609-664-8381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1095237101YS0200X
NJ37AC00449900101YM0800X
NJ37PC00795200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool