Individual provider Active NPI

Ivannia Alay, ASW

  • Mental Health Counselor
  • San Bernardino, CA
National Provider Identifier
1184194383
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ASW85546 Issued in CA
Practice address
1738 N Waterman Ave Ste 1
San Bernardino, CA 92404-5131
Phone
(909) 693-3302
Fax
(909) 474-9610
NPI assigned
Nov 29, 2018
Last updated
Nov 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW85546 CA Primary

Addresses

Primary practice location

1738 N Waterman Ave Ste 1
San Bernardino, CA 92404-5131

Mailing address

1738 N Waterman Ave Ste 1
San Bernardino, CA 92404-5131
Phone (909) 693-3302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211003437 CA Practitioner - Clinical Social Worker 3678009883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spring to Autumn Family Counseling, Inc.Group PAC ID 1254773054, 18 clinicians

Practice addresses (Care Compare)

2068 Orange Tree LN
Suite 216
Redlands, CA 92374-4555
Phone (909) 557-6574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW85546CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Spring to Autumn Family Counseling, Inc. CurrentSince Dec 5, 2024 Accepting new patients

Locations

1275 W Park Ave
#7461
Redlands, CA 92373

2068 Orange Tree Ln
Ste 216
Redlands, CA 92374
Phone (909) 553-0448

11870 Pierce St
Ste 150
Riverside, CA 92505
Phone (909) 557-6574

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1184194383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 N WATERMAN AVE STE 1",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045131",
            "telephone_number": "909-693-3302",
            "fax_number": "909-474-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 N WATERMAN AVE STE 1",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045131",
            "telephone_number": "909-693-3302",
            "fax_number": "909-474-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAY",
        "first_name": "IVANNIA",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW85546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.