MEDICARE: RODRIGO CORREA LPSY,LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	TPMC4070	FL
2	101YM0800X	Mental Health Counselor	003580	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891862348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODRIGO CORREA LPSY,LMHC

Provider Business Mailing Address
First Line	:	1546 MADISON AVE APT 4B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-4553
Country	:	US
Telephone Number	:	347-681-8628
Fax Number	:

Provider Business Practice Location Address
First Line	:	1546 MADISON AVE APT 4B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-4553
Country	:	US
Telephone Number	:	347-681-8628
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	02/01/2025

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