Individual provider Active NPI

Allyson L Corella, MS, MFT, LCADC

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1972901072
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2631 Issued in NV
Practice address
1640 Alta Dr Ste 4
Las Vegas, NV 89106-4165
Phone
(702) 474-6450
Fax
(702) 474-6463
NPI assigned
Dec 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 06720-LC NV
Marriage & Family Therapist 106H00000X 2631 NV Primary

Addresses

Primary practice location

1640 Alta Dr Ste 4
Las Vegas, NV 89106-4165

Mailing address

4221 McLeod Dr
Las Vegas, NV 89121-5215
Phone (702) 474-6450

Other practice location 1

4221 McLeod Dr
Las Vegas, NV 89121-5215
Phone (702) 474-6450

Other names 1

  • Allyson Loaiza-Ibarra Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250501001258 NV Practitioner - Marriage and Family Therapist 2163948225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridge Counseling Associates IncGroup PAC ID 4486914975, 16 clinicians

Practice addresses (Care Compare)

4221 McLeod Dr
Las Vegas, NV 89121-5215
Phone (702) 474-6450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
06720-LCNVMDAddiction (Substance Use Disorder) Counselor
2631NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge Counseling Associates, Inc CurrentSince Feb 8, 2025 Accepting new patients
Bridge Counseling Associates, Inc Current Accepting new patients

Locations

1640 Alta Dr
Ste 4
Las Vegas, NV 89106
Phone (702) 474-6450

4221 McLeod Dr
Las Vegas, NV 89121
Phone (702) 474-6450

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f9a6475a-3dbd-47b2-979a-55064cfdbd51/

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": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1972901072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 MCLEOD DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215215",
            "telephone_number": "702-474-6450",
            "fax_number": "702-474-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 ALTA DR STE 4",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064165",
            "telephone_number": "702-474-6450",
            "fax_number": "702-474-6463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4221 McLeod Dr",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891215215",
            "country_code": "US",
            "telephone_number": "702-474-6450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORELLA",
        "first_name": "ALLYSON",
        "middle_name": "L",
        "credential": "MS, MFT, LCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "06720-LC",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "2631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLYSON",
            "last_name": "LOAIZA-IBARRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.