Ivis M Carrera Valdes

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH19960 Issued in FL

Practice address

1501 S Pinellas Ave Ste P
Tarpon Springs, FL 34689-1952

Phone

(727) 547-3692

NPI assigned

Mar 13, 2012

Last updated

Feb 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1801161666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 THRACE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336056353",
            "telephone_number": "813-562-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S PINELLAS AVE STE P",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346891952",
            "telephone_number": "727-547-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRERA VALDES",
        "first_name": "IVIS",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH19960",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Tarpon Springs, FL
• Providers in Tarpon Springs, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.