Kevin Mark Correia, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

31520 Issued in TX

Practice address

8155 Gladys Ave
Beaumont, TX 77706

Phone

(409) 860-4007

Fax

(409) 860-1762

NPI assigned

Aug 30, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senior Psychological Care I LLCGroup PAC ID 1557535226, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Senior Psychological Care I, LLC

  • Psychologist
  • Houston, TX
  • NPI 1245526490

  Clinical

  Medicare reassignment Care Compare group NPD
• Spindletop MHMR Services

  • Family Medicine Physician
  • Beaumont, TX
  • NPI 1952357550
  Medicare reassignment NPD
• Spindletop MHMR Services

  • Mental Health Counselor
  • Beaumont, TX
  • NPI 1467517656
  NPD

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1194718650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8155 GLADYS AVE",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063243",
            "telephone_number": "409-860-4007",
            "fax_number": "409-860-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8155 GLADYS AVE",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77706",
            "telephone_number": "409-860-4007",
            "fax_number": "409-860-1762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 9th Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Port Arthur",
            "state": "TX",
            "postal_code": "776428076",
            "country_code": "US",
            "telephone_number": "409-860-4007",
            "fax_number": "409-860-1762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2750 S 8th St",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777017719",
            "country_code": "US",
            "telephone_number": "409-839-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORREIA",
        "first_name": "KEVIN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31520",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "TX",
            "license": "31520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0051GZ",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7473360",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "305188",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507170-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Cormier
• Cesily Caldwell Cormier, MSN, ACNP-BC
• Paul Wayne Cormier, N.P.
• Cornerstone Family Health Center PLLC
• Tiffany April Coronado, DC, PHARMD
• Rui Paulo Correia, APRN-CNP
• Cosmos Hospice of Beaumont, LLC
• Cynthia Costa
• Counseling and Relief Everyday Mental Health Center
• Country Road Emergency Physicians, PLLC

• Clinical Psychologist in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.