Individual provider Active NPI

Jazmin Santamaria Perez, LMHC, CRC

  • Mental Health Counselor
  • Pompano Beach, FL
National Provider Identifier
1104512300
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH23484 Issued in FL
Practice address
2637 E Atlantic Blvd Ste 1029
Pompano Beach, FL 33062-4939
Phone
(954) 520-7033
NPI assigned
Apr 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 MH23484 FL Primary

Addresses

Primary practice location

2637 E Atlantic Blvd Ste 1029
Pompano Beach, FL 33062-4939

Mailing address

2637 E Atlantic Blvd Ste 1029
Pompano Beach, FL 33062-4939
Phone (954) 520-7033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240513002300 FL Practitioner - Mental Health Counselor 9638510340 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Florida Inc Mental Health CurrentSince Aug 18, 2025 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Apr 3, 2024 Accepting new patients

Locations

10100 W Sample Rd
Ste 205
Coral Springs, FL 33065
Phone (561) 771-5838

2425 E Commercial Blvd
Ste 405
Fort Lauderdale, FL 33308
Phone (754) 400-5514

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1104512300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 E ATLANTIC BLVD STE 1029",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330624939",
            "telephone_number": "954-520-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 E ATLANTIC BLVD STE 1029",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330624939",
            "telephone_number": "954-520-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTAMARIA PEREZ",
        "first_name": "JAZMIN",
        "credential": "LMHC, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH23484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.