Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marly Ayala-Icaza, MH14786

Individual provider Mental Health Counselor · NPI 1821412230

Marly Ayala-Icaza, MH14786 is a Mental Health Counselor in Bradenton, Florida. Qualified in 2010, 16 years ago. Practices with Optum Behavioral Care of North Carolina PC, a 176-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
16
Licensed in
FL
In the registry since
2014
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Practice location Address checks out

3500 El Conquistador Pkwy Apt 259 Apt 259
Bradenton, FL 34210-3819
Phone: (954) 806-3698
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence IMH2387 (FL)

Record details

NPI number1821412230
Entity typeIndividual (Type 1)
GenderFemale
Credentials MH14786
Sole proprietorNo
NPI enumeratedFebruary 6, 2014
Last updated in NPPESFebruary 5, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Optum Behavioral Care Of North Carolina Pc — 176 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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