NPIMap

Organization Active NPI

Achieve Wellness Group LLC

  • Clinical Psychologist
  • Tampa, FL
National Provider Identifier
1669619342
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 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
Last updated
Mar 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Authorized official

Name
Dr. Lisa Iannelli Correa, PSYDNPI 1033308788
Title
President
Phone
(888) 531-1313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X Primary
Clinical Social WorkerGroup: 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

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

National Provider Directory

Locations

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

13039 W Linebaugh Ave
Ste 101
Tampa, FL 33626
Phone (352) 515-6914

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299628800000",
    "number": "1669619342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13039 W LINEBAUGH AVE",
            "address_2": "BUILDING V, SUITE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264483",
            "telephone_number": "888-531-1313",
            "fax_number": "888-551-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13039 W LINEBAUGH AVE",
            "address_2": "BUILDING V, SUITE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264483",
            "telephone_number": "888-531-1313",
            "fax_number": "888-551-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACHIEVE WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2011-03-09",
        "status": "A",
        "authorized_official_last_name": "CORREA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "IANNELLI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-531-1313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.