Individual provider Active NPI

Seida Perez, LMHC

  • Mental Health Counselor
  • Dade City, FL
National Provider Identifier
1023327350
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH12740 Issued in FL
Practice address
36739 Sr 52
Suite 207B
Dade City, FL 33525
Phone
(813) 712-0188
Fax
(813) 618-3945
NPI assigned
Oct 5, 2010
Last updated
Dec 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH12740 FL Primary

Addresses

Primary practice location

36739 Sr 52
Suite 207B
Dade City, FL 33525

Mailing address

36739 State Road 52
Suite 207B
Dade City, FL 33525-5101
Phone (813) 712-0188

Other identifiers 1

IdentifierTypeStateIssuer
012638900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH12740FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1023327350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36739 STATE ROAD 52",
            "address_2": "SUITE 207B",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255101",
            "telephone_number": "813-712-0188",
            "fax_number": "813-618-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36739 SR 52",
            "address_2": "SUITE 207B",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "33525",
            "telephone_number": "813-712-0188",
            "fax_number": "813-618-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "SEIDA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012638900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dade City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.