Individual provider Active NPI

Corrieann Marie Avila, LCSW

  • Clinical Social Worker
  • Doral, FL
National Provider Identifier
1952731960
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009572 Issued in VA
Practice address
8352 NW 52 Terrace
Doral, FL 33166
Phone
(786) 551-9550
NPI assigned
Nov 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW13377 FL
Clinical Social Worker 1041C0700X 0904009572 VA Primary

Addresses

Primary practice location

8352 NW 52 Terrace
Doral, FL 33166

Mailing address

8352 NW 52ND Ter
Doral, FL 33166-7704
Phone (954) 319-5038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2026 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW13377FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch Counseling Group, LLC Clinical CurrentSince Nov 12, 2023 Accepting new patients
Prince William Family Counseling, P.C. PastSince Sep 1, 2019 Accepting new patients

Locations

5335 NW 87th Ave
Ste C109
Doral, FL 33178
Phone (786) 551-9550

Organizations & group practices 2

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": "1384300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1952731960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8352 NW 52ND TER",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331667704",
            "telephone_number": "954-319-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8352 NW 52 TERRACE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "33166",
            "telephone_number": "786-551-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "CORRIEANN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-13",
        "last_updated": "2023-11-06",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13377",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.