Provider Demographics
NPI:1972901072
Name:CORELLA, ALLYSON L (MS, MFT, LCADC)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:L
Last Name:CORELLA
Suffix:
Gender:
Credentials:MS, MFT, LCADC
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:
Other - Last Name:LOAIZA-IBARRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4221 MCLEOD DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5215
Mailing Address - Country:US
Mailing Address - Phone:702-474-6450
Mailing Address - Fax:702-474-6463
Practice Address - Street 1:1640 ALTA DR STE 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4165
Practice Address - Country:US
Practice Address - Phone:702-474-6450
Practice Address - Fax:702-474-6463
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV06720-LC101YA0400X
NV2631106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)