Healthcare Provider Details

I. General information

NPI: 1356687230
Provider Name (Legal Business Name): SHALIM SHAEL RAMOS PEREZ LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2012
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4747 US HIGHWAY 19
NEW PORT RICHEY FL
34652-4945
US

IV. Provider business mailing address

7901 4TH ST N # 9431
ST PETERSBURG FL
33702-4305
US

V. Phone/Fax

Practice location:
  • Phone: 727-321-3854
  • Fax: 727-327-7670
Mailing address:
  • Phone: 656-232-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number26809
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: