Individual provider Active NPI

Lynn Ward Corella, MA, LMHC

  • Mental Health Counselor
  • Safety Harbor, FL
National Provider Identifier
1760676175
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00010739 Issued in WA
Practice address
2185 Bow LN
Safety Harbor, FL 34695-2235
Phone
(352) 769-1953
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH-00010739
Mental Health Counselor 101YM0800X 0102871 NM
Mental Health Counselor 101YM0800X 94607
Professional Counselor 101YP2500X MH17885 FL
Registered Dietitian 133V00000X 666309
Mental Health Counselor 101YM0800X LH00010739 WA Primary

Addresses

Primary practice location

2185 Bow LN
Safety Harbor, FL 34695-2235

Mailing address

2185 Bow LN
Safety Harbor, FL 34695-2235
Phone (352) 769-1953

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
I20240311000146 FL Practitioner - Mental Health Counselor 8325484587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

Jacksonville, FL 32211
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0102871NMMDMental Health Counselor
LH00010739WAMDMental Health Counselor
MH17885FLMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Health, Inc. CurrentSince Mar 5, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

6501 Arlington Expy
Ste B105
Jacksonville, FL 32211
Phone (904) 302-9355

Organizations & group practices 1

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": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1760676175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 BOW LN",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346952235",
            "telephone_number": "352-769-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 BOW LN",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346952235",
            "telephone_number": "352-769-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORELLA",
        "first_name": "LYNN",
        "middle_name": "WARD",
        "name_prefix": "Ms.",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "LH-00010739",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0102871",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "94607",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH17885",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "666309",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00010739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

Verify at the official NPI Registry.