OLIVIA MARIE CORALLO MS, LCAS-A, LCMHC-A
NPI 1447821145
Counselor - Professional in Jacksonville, NC

Q: What is Olivia Corallo's NPI number?

The NPI number for Olivia Corallo is 1447821145. It was assigned to this individual provider in the NPPES registry on July 5, 2021.

Q: What is Olivia Corallo's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Olivia Corallo was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 05, 2021PECOS Enrolled

200 TARPON TRL, JACKSONVILLE, NC 28546(910) 938-1114(910) 938-1118 Get Directions Write a Review

NPPES record last updated: July 6, 2023. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Jul 6, 2023, Aug 11, 2021, Jul 5, 2021 (3 updates tracked since 2021).

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About Olivia Marie Corallo Ms, Lcas-a, Lcmhc-a NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLIVIA MARIE CORALLO MS, LCAS-A, LCMHC-A (NPI 1447821145) is an individual professional provider in Jacksonville, North Carolina, licensed in North Carolina (16814) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1447821145

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameOLIVIA MARIE CORALLOCredential: MS, LCAS-A, LCMHC-A

Location Address200 TARPON TRLJacksonville, NC 28546-5287

Mailing Address200 Tarpon TrlJacksonville, NC 28546-5287 · (910) 938-1114 · Fax (910) 938-1118

Phone(910) 938-1114

Fax(910) 938-1118

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 5, 2021

Last NPPES UpdateJuly 6, 20233 updates tracked since enumeration

NPPES CertifiedJuly 6, 2023

✔ NPI 1447821145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in NC · 16814

200 TARPON TRL, Jacksonville, NC 28546

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Olivia Marie Corallo Ms, Lcas-a, Lcmhc-a is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698127686

PECOS Enrollment IDI20240116000054

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMANDA ASHLEY MANNING LCSW-A

Social Worker (Clinical)