Provider Demographics
NPI:1902524135
Name:PEREZ, MICHAELA LYNN (QMHP)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:LYNN
Last Name:PEREZ
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:KAELI
Other - Middle Name:LYNN
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:QMHP
Mailing Address - Street 1:1585 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4978
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:212 N DUNTON AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5915
Practice Address - Country:US
Practice Address - Phone:847-848-1098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health