Clarissa Amor Peralta, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

61113 Issued in TX

Practice address

1700 Waterman St
Detroit, MI 48209-2022

Phone

(915) 613-7674

NPI assigned

Feb 5, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1104240688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 WATERMAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482092022",
            "telephone_number": "915-613-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WATERMAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482092022",
            "telephone_number": "915-613-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "CLARISSA",
        "middle_name": "AMOR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "61113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Peoples
• Sharmela Peoples
• Taylor Mae Peoples
• Carrie K Peraino, ANP-BC
• Angel Rolando Peralta-Avila, MD
• Damon Z Percy
• Zaniya E Perdue
• Kathie Ann Pereira, MSN, FNP-BC
• Ruth M Pereira, M.D
• Edward M Peres, MD

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.