Individual provider Active NPI

Caroline Perjessy, LMHC

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1902921042
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C0602014 Issued in OH
Practice address
11640 Greensleeve Ave # NA
Tampa, FL 33626-2678
Phone
(404) 783-6193
NPI assigned
Mar 20, 2007
Last updated
Jul 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH16101 FL
Mental Health Counselor 101YM0800X C0602014 OH Primary

Addresses

Primary practice location

11640 Greensleeve Ave # NA
Tampa, FL 33626-2678

Mailing address

11640 Greensleeve Ave # NA
Tampa, FL 33626-2678
Phone (404) 783-6193

Other identifiers 1

IdentifierTypeStateIssuer
0803312MedicaidOH

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
I20250627002490 FL Practitioner - Mental Health Counselor 7214440882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Step Up Care LLCGroup PAC ID 9234468778, 8 clinicians

Practice addresses (Care Compare)

7000 W Palmetto Park Rd
Suite 308
Boca Raton, FL 33433-3429
Phone (718) 506-1115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH16101FLMDMental Health Counselor
C0602014OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Mental Health Services - FL Gulf SW LLC CurrentSince Jun 16, 2025 Accepting new patients
Allied Behavioral Health Services, Incorporated Past Accepting new patients

Locations

5350 Gulf of Mexico Dr
Ste 203
Longboat Key, FL 34228
Phone (941) 210-0384

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1902921042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11640 GREENSLEEVE AVE # NA",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262678",
            "telephone_number": "404-783-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11640 GREENSLEEVE AVE # NA",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262678",
            "telephone_number": "404-783-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERJESSY",
        "first_name": "CAROLINE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16101",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C0602014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0803312",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.