Active NPI
Olivia R Perin, LCSW
- Clinical Social Worker
- Orlando, FL
National Provider Identifier
1811259351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1010 Executive Center Dr Ste 100
Orlando, FL 32803-3521 - Phone
- (407) 730-1309
- Fax
- (866) 936-3829
- NPI assigned
- Jun 11, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SW11135 | FL | |
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
1010 Executive Center Dr Ste 100
Orlando, FL 32803-3521
Mailing address
1010 Executive Center Dr Ste 100
Orlando, FL 32803-3521
Phone (407) 730-1309
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 029573621 | Medicaid | FL |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703030400000",
"number": "1811259351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 EXECUTIVE CENTER DR STE 100",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328033521",
"telephone_number": "407-730-1309",
"fax_number": "866-936-3829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 EXECUTIVE CENTER DR STE 100",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328033521",
"telephone_number": "407-730-1309",
"fax_number": "866-936-3829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERIN",
"first_name": "OLIVIA",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-11",
"last_updated": "2023-12-20",
"certification_date": "2023-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "SW11135",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "029573621",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.