Elena C Coello-Jemmali, PSYD
Individual provider Active NPI Psychologist · Pinecrest, FL
NPI 1972564664 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1972564664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PY4371 (FL)
- Practice address
- 9729 S Dixie Hwy
Pinecrest, FL 33156-2806 - Phone
- (305) 740-3038
- Fax
- (305) 740-3038
- NPI assigned
- Mar 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
14707 S Dixie Hwy
Suite 211
Palmetto Bay, FL 33176-7951
Phone (305) 233-2010
206 Princeton Rd
Suite 41
Johnson City, TN 37601-2025
Phone (305) 233-2010
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090105000422 | FL | Practitioner - Clinical Psychologist | 7810893260 | Reassigns benefits to 1 organization |
| I20230817002352 | TN | Practitioner - Clinical Psychologist | 7810893260 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY4371 | FL | MD | Psychologist |
| 3833 | TN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY4371 | FL | Yes |
Addresses
Primary practice location
9729 S Dixie Hwy
Pinecrest, FL 33156-2806
Mailing address
9729 S Dixie Hwy
Pinecrest, FL 33156-2806
Phone (305) 740-3038
Other providers in Pinecrest, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.