Individual provider Active NPI

Aliris Alicea, LMHC, CCMHC, NCC

  • Mental Health Counselor
  • Lakeland, FL
National Provider Identifier
1407099526
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12095 Issued in FL
Practice address
1813 Via Lago Dr
Lakeland, FL 33810-2418
Phone
(407) 603-6460
NPI assigned
Apr 20, 2009
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12095 FL Primary
Professional Counselor 101YP2500X 2133 PR
Professional Counselor 101YP2500X 6810 CT
Professional Counselor 101YP2500X 37PC00837800 NJ

Addresses

Primary practice location

1813 Via Lago Dr
Lakeland, FL 33810-2418

Mailing address

1201 1St St S
Winter Haven, FL 33880-3904
Phone (863) 294-7062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231120001344 FL Practitioner - Mental Health Counselor 4284082959 Reassigns benefits to 1 organization
I20250808001263 NJ Practitioner - Mental Health Counselor 4284082959 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12095FLMDMental Health Counselor
6810CTMDProfessional Counselor
2133PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Winter Haven Hospital Inc CurrentSince Jan 1, 2024 Accepting new patients
Optum Behavioral Care of New Jersey, P.C. CurrentSince Sep 15, 2025 Accepting new patients
Winter Haven Hospital Inc CurrentSince Jan 1, 2024 Accepting new patients
Optum Behavioral Care of New Jersey, P.C. CurrentSince Sep 15, 2025 Accepting new patients
Grow Healthcare Group of New Jersey PC Mental Health CurrentSince Jul 1, 2025 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1201 1st St S
Winter Haven, FL 33880
Phone (863) 294-7062

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

595 Shrewsbury Ave
Ste 205
Shrewsbury, NJ 07702
Phone (732) 675-3451

616 Washington St
Ste 2
Toms River, NJ 08753

Interoperability endpoints

  • Direct secure messaging: aliris.alicealmhc@direct.mybaycare.org

Organizations & group practices 5

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": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1407099526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803904",
            "telephone_number": "863-294-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 VIA LAGO DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338102418",
            "telephone_number": "407-603-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICEA",
        "first_name": "ALIRIS",
        "name_prefix": "Dr.",
        "credential": "LMHC, CCMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "12095",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PR",
            "license": "2133",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "6810",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00837800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.