Provider Demographics
NPI:1154987816
Name:PEREZ LEON, DAIMARY E (LCSW)
Entity type:Individual
Prefix:
First Name:DAIMARY
Middle Name:E
Last Name:PEREZ LEON
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 1:6300 CORPORATE CT STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3513
Mailing Address - Country:US
Mailing Address - Phone:239-257-7076
Mailing Address - Fax:
Practice Address - Street 1:1121 CALVERT AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-8514
Practice Address - Country:US
Practice Address - Phone:239-257-7076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-17
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW220001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical