MARILOURDES PEREZ (MA, LMHC) – Mental Health Counselor, NPI 1124366430

MARILOURDES PEREZ (MA, LMHC) is a healthcare provider. based in Port orange, Florida. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LMHC. They hold a License No. MH13815 (FL). The NPI Number for MARILOURDES PEREZ (MA, LMHC) is 1124366430

Main info

Female
Sole Proprietor
19 Years Of Experience
Accepts Medicare Assignment
Name
MARILOURDES PEREZ (MA, LMHC)
NPI
1124366430
Phone
(386) 310-7436
Address
3930 S NOVA RD STE 303
Enumeration Date
21 January 2013
Last Update Date
23 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3219729215
Graduation Year
2007 (19 years ago)
PAC ID
3072043439
Group Practice PAC ID
0345659868
Professional Enrollment ID
I20250214000080
Address ID
FL327142502AL108XXSTXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

3,018 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for MARILOURDES PEREZ (MA, LMHC)

  • 3930 S NOVA RD STE 303

    PORT ORANGE, FL 321279293

    Phone: (386) 310-7436

    Fax: (386) 259-6112

    Type: Location

  • 840 DELTONA BLVD STE K

    DELTONA, FL 327257162

    Phone: (386) 860-1776

    Fax: (386) 860-1060

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250214000080IMental Health CounselorFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32127)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345659868View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Clinical Social WorkerFL
Mental Health CounselorFL
Mental Health CounselorFL
Clinical Social WorkerFL
Nurse PractitionerFL
Nurse PractitionerFL
Mental Health CounselorFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What unique ID ties claims to MARILOURDES PEREZ (MA, LMHC)?
NPI 1124366430 is assigned to MARILOURDES PEREZ (MA, LMHC) under the national enumeration system.
Is MARILOURDES PEREZ (MA, LMHC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does MARILOURDES PEREZ (MA, LMHC) list a primary specialty?
If you are matching referrals, note Mental Health Counselor for MARILOURDES PEREZ (MA, LMHC). Clinical services aligned with this taxonomy classification.
What location shows for MARILOURDES PEREZ (MA, LMHC)?
We surface Port Orange, Florida for MARILOURDES PEREZ (MA, LMHC) based on available NPPES addresses.
Is MARILOURDES PEREZ (MA, LMHC) a real provider?
This page reflects official NPPES data for NPI 1124366430. Always confirm identity and privileges with the practice and licensing boards.