Individual provider Active NPI

Lily Joann Corsello, D.MIN

  • Mental Health Counselor
  • Big Pine Key, FL
National Provider Identifier
1821162363
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4676 Issued in FL
Practice address
100 County Rd
Big Pine Key, FL 33043-4823
Phone
(954) 822-8874
Fax
(305) 741-7971
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4676 FL Primary
Professional Counselor 101YP2500X 13064 TX

Addresses

Primary practice location

100 County Rd
Big Pine Key, FL 33043-4823

Mailing address

27332 Dominica LN
Ramrod Key, FL 33042-5453
Phone (954) 822-8874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13064TXMDProfessional Counselor
4676FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
In Spirit and in Truth Counseling Services, Inc. Mental Health Past Accepting new patients

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1821162363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27332 DOMINICA LN",
            "city": "RAMROD KEY",
            "state": "FL",
            "postal_code": "330425453",
            "telephone_number": "954-822-8874",
            "fax_number": "305-741-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY RD",
            "city": "BIG PINE KEY",
            "state": "FL",
            "postal_code": "330434823",
            "telephone_number": "954-822-8874",
            "fax_number": "305-741-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSELLO",
        "first_name": "LILY",
        "middle_name": "JOANN",
        "name_prefix": "Dr.",
        "credential": "D.MIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "4676",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "13064",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Pine Key, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.