Alexis Llemal Perez-Medina, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

906 Main Ave
Tillamook, OR 97141-3816

Phone

(503) 842-8201

Fax

(503) 815-1870

NPI assigned

Jul 26, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mr. Alex Perez Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.alexisperezmedina@148835.advancedmd-direct.com
• FHIR API: https://api.qualifacts.org/api/fhir/tfcc/r4/

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.

• Tillamook Family Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tillamook, OR
  • NPI 1659380145
  NPD
• Tillamook Family Counseling Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tillamook, OR
  • NPI 1063623478
  NPD (past)

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1992258958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413816",
            "telephone_number": "503-842-8201",
            "fax_number": "503-815-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413816",
            "telephone_number": "503-842-8201",
            "fax_number": "503-815-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-MEDINA",
        "first_name": "ALEXIS",
        "middle_name": "LLEMAL",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500714618",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEX",
            "last_name": "PEREZ",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Patricia a. Blondo, LLC
• Kathryn R Patrick, MSW
• Carol Patterson
• Sarah Rose Patterson
• Melissa Paulissen, M.D.
• Cassandra Persons
• Julie Peters Brainerd, RN
• Therese Thuytien Pham
• Alexandria Pilkington, PHARMD
• Todd A Pitts, MD

• Mental Health Counselor in Tillamook, OR
• Providers in Tillamook, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.