Marilourdes Perez, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH13815 Issued in FL

Practice address

3930 S Nova Rd Ste 303
Port Orange, FL 32127-9293

Phone

(386) 310-7436

Fax

(386) 259-6112

NPI assigned

Jan 21, 2013

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

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

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifes Path LLCGroup PAC ID 6608313481, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Lifes Path LLC

  • Mental Health Counselor
  • Deland, FL
  • NPI 1013753235
  Medicare reassignment Care Compare group
• Advanced Behavioral Health Center PA

  • Psychiatry Physician
  • Tavares, FL
  • NPI 1043378730
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment NPD
• Chrysalis Counseling Center LLC

  • Mental Health Counselor
  • Port Orange, FL
  • NPI 1356956114
  NPD
• Healing Psychiatry of Florida Inc

  • Addiction Psychiatry Physician
  • Altamonte Springs, FL
  • NPI 1265018162
  NPD

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1124366430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 S NOVA RD STE 303",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279293",
            "telephone_number": "386-310-7436",
            "fax_number": "386-259-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 S NOVA RD STE 303",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279293",
            "telephone_number": "386-310-7436",
            "fax_number": "386-259-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MARILOURDES",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-21",
        "last_updated": "2021-11-23",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13815",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ZZ",
            "license": "MH13815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Clark Pennell, PHD
• Aleah Pennisi
• Alison Penrod
• Ashley Perez Moreno
• Kristal Xiomara Perez, DC
• Performance Physical Therapy of Port Orange
• Performance Physical Therapy, LLC
• Personal Touch Fitting
• Tori Persons
• Perspective Mental Health Counseling, LLC

• Mental Health Counselor in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.