Shawn Lee Peverly, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH14774 Issued in FL

Practice address

375 Cortez Ave
De Leon Springs, FL 32130-3340

Phone

(407) 617-6236

NPI assigned

Nov 27, 2017

Last updated

Apr 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shawn Lee Johnson Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: No
• 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Solid Ground Counseling

  • Community/Behavioral Health Agency
  • Deland, FL
  • NPI 1356081988
  Medicare reassignment NPD

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1952815029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 CORTEZ AVE",
            "city": "DE LEON SPRINGS",
            "state": "FL",
            "postal_code": "321303340",
            "telephone_number": "407-617-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 CORTEZ AVE",
            "city": "DE LEON SPRINGS",
            "state": "FL",
            "postal_code": "321303340",
            "telephone_number": "407-617-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEVERLY",
        "first_name": "SHAWN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "JOHNSON",
            "middle_name": "LEE",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bloom Developmental Services LLC
• Freedom Oaks Assisted Living, Inc.
• Laura Elaine Lore, MACCC-SLP
• John Richards McCormick, M.D.
• Michele McDonough
• Amy Lynn Rider

• Mental Health Counselor in De Leon Springs, FL
• Providers in De Leon Springs, 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 Apr 5, 2024; 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.