Provider Demographics
NPI:1083740625
Name:PEREZ, KAREN A (PSYD, PHD, LLP, LPC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PSYD, PHD, LLP, LPC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:SCHULZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, PHD, LLP, LPC
Mailing Address - Street 1:705 S MAIN ST STE 101I
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1060
Mailing Address - Country:US
Mailing Address - Phone:734-748-5796
Mailing Address - Fax:734-468-0109
Practice Address - Street 1:705 S MAIN ST STE 101I
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1060
Practice Address - Country:US
Practice Address - Phone:734-748-5796
Practice Address - Fax:734-468-0109
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011072103T00000X
MI6401002271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist