Provider Demographics
NPI:1407620743
Name:PERLMAN, KATELYNN (LPC)
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:
Last Name:PERLMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 N SIOUX DR
Mailing Address - Street 2:
Mailing Address - City:CHINO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86323-4656
Mailing Address - Country:US
Mailing Address - Phone:928-968-4585
Mailing Address - Fax:
Practice Address - Street 1:2420 N SIOUX DR
Practice Address - Street 2:
Practice Address - City:CHINO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86323-4656
Practice Address - Country:US
Practice Address - Phone:928-968-4585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-22586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional