Corey Carlyon, LPC
Individual provider Active NPI Mental Health Counselor · Hutto, TX
NPI 1104516509 · NPPES record last updated Jun 12, 2025
Key facts
- NPI
- 1104516509
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 90257 (TX)
- Practice address
- 412 Ballentine CT
Hutto, TX 78634-4195 - Phone
- (406) 214-4221
- NPI assigned
- May 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250602001746 | TX | Practitioner - Mental Health Counselor | 1951810951 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90257 | TX | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thriving Lane | Current |
Accepting new patients | |
| St Health TX, P.a. | Past | Accepting new patients |
Locations
200 2nd Ave S
St Petersburg, FL 33701
Phone (727) 465-8515
3571 Far West Blvd
Austin, TX 78731
Phone (512) 567-4737
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 90257 | TX | Yes |
Addresses
Primary practice location
412 Ballentine CT
Hutto, TX 78634-4195
Mailing address
412 Ballentine CT
Hutto, TX 78634-4195
Other providers in Hutto, TX
- Trisha Burky
- Natasha Burton
- Arial Caldera
- Marcia Ann Caldwell
- Lea Christine Campbell
- Wendy Carrizales
- Carus Dental PC
- Anthony Cavazos-Geluso
- Allison Certosimo
- Isaac Emmanuel Cha
All providers in Hutto, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.