Individual provider Active NPI

Ivelisse Correa, M.A

  • Mental Health Counselor
  • Ocala, FL
National Provider Identifier
1972982155
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16164 Issued in FL
Practice address
2497 SW 27TH Ave # 1096
Ocala, FL 34471-0807
Phone
(352) 322-8747
NPI assigned
May 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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
Mental Health Counselor 101YM0800X MH16164 FL Primary

Addresses

Primary practice location

2497 SW 27TH Ave # 1096
Ocala, FL 34471-0807

Mailing address

PO Box 1266
Summerfield, FL 34492-1266
Phone (352) 322-8747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20250313001446 CT Practitioner - Mental Health Counselor 6103263504 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8186CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestream Behavioral Center Inc Past Accepting new patients

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": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1972982155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1266",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344921266",
            "telephone_number": "352-322-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2497 SW 27TH AVE # 1096",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344710807",
            "telephone_number": "352-322-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "IVELISSE",
        "credential": "M.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-21",
        "last_updated": "2023-12-01",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.