Achieve Wellness Group LLC

Organization Active NPI Clinical Psychologist · Tampa, FL

NPI 1669619342 · NPPES record last updated Mar 9, 2011

Key facts

NPI
1669619342
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Psychologist 103TC0700X
Legal business name
ACHIEVE WELLNESS GROUP LLC
Practice address
13039 W Linebaugh Ave
Building V, Suite 101
Tampa, FL 33626-4483
Phone
(888) 531-1313
Fax
(888) 551-6035
NPI assigned
Jan 16, 2009
Organization subpart
No

Authorized official

Name
Dr. Lisa Iannelli Correa, PSYD
Title
President
Phone
(888) 531-1313

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090318000249 FL Part B Supplier - Clinic/Group Practice 7113084187 Receives reassigned benefits from 15 practitioners
Practice locations: Spring Hill, FL; Tampa, FL

National Provider Directory

Locations

7020 Mariner Blvd
Spring Hill, FL 34609
Phone (352) 515-6914

13039 W Linebaugh Ave
Bldg V
Tampa, FL 33626

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
103TC0700X Yes
Clinical Social Worker
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1041C0700X

Addresses

Primary practice location

13039 W Linebaugh Ave
Building V, Suite 101
Tampa, FL 33626-4483

Mailing address

13039 W Linebaugh Ave
Building V, Suite 101
Tampa, FL 33626-4483
Phone (888) 531-1313

Other providers in Tampa, FL

All providers in Tampa, FL · Clinical Psychologist in Florida

Sources for this page

Verify at the official NPI Registry.