Provider Demographics
NPI:1316664865
Name:PEREZ, BILLY J (LMSW)
Entity type:Individual
Prefix:
First Name:BILLY
Middle Name:J
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:BILLY
Other - Middle Name:J
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:6129 W BAY CT
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-7765
Mailing Address - Country:US
Mailing Address - Phone:616-889-8713
Mailing Address - Fax:
Practice Address - Street 1:6129 W BAY CT
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-7765
Practice Address - Country:US
Practice Address - Phone:616-889-8713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010984221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical