Individual provider Active NPI

Allison Christina Konovalova, LMFT

  • Marriage & Family Therapist
  • North Miami, FL
National Provider Identifier
1417461393
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT3338 Issued in FL
Practice address
2005 Sans Souci Blvd Apt 301
North Miami, FL 33181-3023
Phone
(561) 497-8178
NPI assigned
Nov 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X MT3338 FL Primary

Addresses

Primary practice location

2005 Sans Souci Blvd Apt 301
North Miami, FL 33181-3023

Mailing address

2005 Sans Souci Blvd Apt 301
North Miami, FL 33181-3023
Phone (561) 497-8178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240304003131 FL Practitioner - Marriage and Family Therapist 0143665802 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Lake Worth, FL 33461
Phone (323) 205-7088

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT3338FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Single Specialty CurrentSince May 1, 2025 Accepting new patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Feb 1, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Marriage & Family Therapist Current Accepting new patients

Locations

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

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

Interoperability endpoints

  • Direct secure messaging: allisonkonovalova@tdh.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1417461393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 SANS SOUCI BLVD APT 301",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813023",
            "telephone_number": "561-497-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 SANS SOUCI BLVD APT 301",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813023",
            "telephone_number": "561-497-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONOVALOVA",
        "first_name": "ALLISON",
        "middle_name": "CHRISTINA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.