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General NPI Number Information
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NPI Number | 1033673298
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Entity Type | Individual
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Provider Name | ANDREA B PEREZ MA, ATR, LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 525 OLD NORTHWEST HWY STE 302-C
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City | BARRINGTON
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State | IL
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Zip | 60010-6814
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Country | US
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Telephone | 847-878-9058
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 NORTHSHORE DR
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City | WAUCONDA
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State | IL
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Zip | 60084-1496
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Country | US
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Telephone | 847-878-9058
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.011606
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License Number State | IL
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