Amanda Victoria Perez, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH15154 Issued in FL

Practice address

4721 E Moody Blvd Ste 204
Bunnell, FL 32110-7706

Phone

(386) 237-8837

NPI assigned

Dec 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Re-Nu Mental Wellness Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Pompano Beach, FL
  • NPI 1598454894
  Medicare reassignment
• Behavioral Health Specialists (de), P.a.

  • Neurology Physician
  • Sugar Land, TX
  • NPI 1831619410

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1780155143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 E MOODY BLVD STE 204",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321107706",
            "telephone_number": "386-237-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 E MOODY BLVD STE 204",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321107706",
            "telephone_number": "386-237-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "AMANDA",
        "middle_name": "VICTORIA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathfinder Advocacy Center
• Patrick Reed DC PA
• Paul Bond, LLC
• Sorrell Grace Penick, BS, SLPA
• Svetlana Perepechkina, PTA
• Tina M Peyton, RN
• Melissa Ann Phillips, MSPH
• Physicians Audiology Services
• Aliah Aquila Price, APRN/FNP
• Hannah Pyles

• Mental Health Counselor in Bunnell, FL
• Providers in Bunnell, 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 Sep 15, 2022; 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.