Individual
MR. JASON M. PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
26 CHAMBERLAIN HWY, KENSINGTON, CT 06037-1921
(860) 893-0040
(860) 893-0046
Mailing address
26 CHAMBERLAIN HWY, KENSINGTON, CT 06037-1921
(860) 893-0040
(860) 893-0046
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
NY
1041C0700X
Clinical Social Worker
Primary
009769
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/10/2012
Last updated
05/05/2017
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