Mauricio Perez, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61455329 Issued in WA

Practice address

12020 Sunrise Blvd E Apt J107
Puyallup, WA 98374-8017

Phone

(253) 797-0331

NPI assigned

Nov 5, 2013

Last updated

Dec 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 WA

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

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678
  Medicare reassignment Care Compare group NPD
• Catholic Community Services of Western Washington

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1790180214
  NPD (past)

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1366871824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 SUNRISE BLVD E APT J107",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748017",
            "telephone_number": "253-797-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 SUNRISE BLVD E APT J107",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748017",
            "telephone_number": "253-797-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MAURICIO",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61455329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer N Pense, DO
• Isabel Perez Bescanza
• Carolina Perez Placencia, LICSW
• Cris Perez, DO
• Jamie Ivan Perez
• Performance Modalities Inc (Performance Home Medical)
• Kristin Kae Perkins, MS SLP
• Tasha Nicole Perkins, LMFTA
• Mark Perpose, DNP, ARNP, PMHNP-BC
• Personal Injury Imaging, LLC

• Clinical Social Worker in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.