Callie Bridges Perez, MA, LPCA, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A13374 Issued in NC

Practice address

280 Executive Park Dr
Concord, NC 28025-1837

Phone

(704) 237-4240

NPI assigned

Jan 24, 2018

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mimosa Christian Counseling Center, Inc

  • Mental Health Counselor
  • Morganton, NC
  • NPI 1902957160
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1346748431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "MOORESBORO",
            "state": "NC",
            "postal_code": "281140191",
            "telephone_number": "704-466-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251837",
            "telephone_number": "704-237-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CALLIE",
        "middle_name": "BRIDGES",
        "name_prefix": "Mrs.",
        "credential": "MA, LPCA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A13374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lachundra Pemberton
• Corey L Pena, C.O.
• Karime Penunuri
• Jessica Ann Peoples, PA
• Morgan Pepper, PH.D., LCMHCA, CRC
• Dominique Perez
• Jasiel Perez
• Perigon Pediatric Therapy and Consulting
• Lariise Nicole Perkins
• Linda Perkins

• Professional Counselor in Concord, NC
• Providers in Concord, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.