Manasa K Perera, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009262 Issued in IL

Practice address

820 Shannon Lake CT
Westmont, IL 60559-2593

Phone

(312) 515-7841

NPI assigned

May 5, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MKP Psychology

  • Clinical Psychologist
  • Westmont, IL
  • NPI 1134801780
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1447606751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SHANNON LAKE CT",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605592593",
            "telephone_number": "312-515-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 SHANNON LAKE CT",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605592593",
            "telephone_number": "312-515-7841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8170 McCormick Blvd",
            "address_2": "204",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600762961",
            "country_code": "US",
            "telephone_number": "847-673-0718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERERA",
        "first_name": "MANASA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009262",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSURE FOR CLINICAL PSYCHOLOGIST",
            "identifier": "071009262",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mpereraphd@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "820 Shannon Lake Ct",
            "city": "Westmont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605592593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alysia Pavlenko Medina, LPC
• Pamela Pawelski, LCSW
• Szechuan Z Payne
• Karen A Pecha, LCSW
• Laura Catherine Peppers, D.C.
• Itay Perets, SA
• Performance Medical Systems, Inc
• Kelly Perillo, PA
• Angela Pescatore
• Elizabeth K Peter, MS, OTRL

• Clinical Psychologist in Westmont, IL
• Providers in Westmont, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.