Provider Demographics
NPI:1386890853
Name:PERPICH, MICHELLE ANN (LMSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:PERPICH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 OVID AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-3543
Mailing Address - Country:US
Mailing Address - Phone:515-321-4668
Mailing Address - Fax:
Practice Address - Street 1:4325 OVID AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-3543
Practice Address - Country:US
Practice Address - Phone:515-321-4668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007097104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker