Active NPI
Lynn Ward Corella, MA, LMHC
- Mental Health Counselor
- Safety Harbor, FL
National Provider Identifier
1760676175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH00010739
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0102871 | NM | MD | Mental Health Counselor |
| LH00010739 | WA | MD | Mental Health Counselor |
| MH17885 | FL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brightside Health, Inc. | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.