Provider Demographics
NPI:1316436074
Name:PEREZ, JOHN DANNY (LPC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DANNY
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6132 BANDERA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1642
Mailing Address - Country:US
Mailing Address - Phone:210-593-4000
Mailing Address - Fax:210-593-4003
Practice Address - Street 1:6132 BANDERA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1642
Practice Address - Country:US
Practice Address - Phone:210-593-4000
Practice Address - Fax:210-593-4003
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74826101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional