Provider Demographics
NPI:1427536002
Name:PERVER, DOROTHY LORRAINE (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:LORRAINE
Last Name:PERVER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:D LORI PERVER, LMHC
Mailing Address - Street 1:1036 GREENLEAF CT
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4411
Mailing Address - Country:US
Mailing Address - Phone:321-591-8568
Mailing Address - Fax:
Practice Address - Street 1:1036 GREENLEAF CT
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-4411
Practice Address - Country:US
Practice Address - Phone:321-591-8568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
FLMH22327101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16002563Other93-3242436
FL101YA0400XMedicaid
16002563OtherCAQH