Rafael Perez, LCSWR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

080213 Issued in NY

Practice address

304 Wall St
Kingston, NY 12401-3850

Phone

(845) 596-2764

NPI assigned

Mar 19, 2014

Last updated

Mar 19, 2014By 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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 15, 2020 through May 15, 2028

Medicare enrollment (NPD)

Enrolled

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

• T Grant PHD

  • Clinical Psychologist
  • New Paltz, NY
  • NPI 1215211719
  NPD

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1568889293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 KRISNAN PL",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125614312",
            "telephone_number": "845-596-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 WALL ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013850",
            "telephone_number": "845-596-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "RAFAEL",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Dentistry of Kingston PLLC (Pediatric Dentistry of Kingston)
• Laurel Pelzek, LCSW-R
• People Incorporated
• Valerie Percy, CCC-SLP
• Ayse Pere, N.P.
• Jeff Perls, LCSWR
• Ralph Michael Perreca, DDS
• Brianne Nicole Perry
• Lorri Ann Perry, AUD
• Paris Perry, DDS

• Clinical Social Worker in Kingston, NY
• Providers in Kingston, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.