Provider Demographics
NPI:1780751925
Name:PERALTA, KARLISTA (LCSW)
Entity type:Individual
Prefix:MISS
First Name:KARLISTA
Middle Name:
Last Name:PERALTA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5424
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77491-5424
Mailing Address - Country:US
Mailing Address - Phone:917-650-1518
Mailing Address - Fax:
Practice Address - Street 1:1160 DAIRY ASHFORD RD STE 115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-3022
Practice Address - Country:US
Practice Address - Phone:832-810-8132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1155391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical