Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Olivia Marie Corallo, MS, LCAS-A, LCMHC-A

Individual provider Professional Counselor · NPI 1447821145

Olivia Marie Corallo, MS, LCAS-A, LCMHC-A is a Mental Health Counselor in Jacksonville, North Carolina. Qualified in 2021, 5 years ago. Offers telehealth. Licensed in North Carolina.

Years since qualifying
5
Licensed in
NC
In the registry since
2021
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.

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Practice location Address checks out

200 Tarpon Trl
Jacksonville, NC 28546-5287
Phone: (910) 938-1114
Fax: (910) 938-1118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 16814 (NC)
Professional Counselor Taxonomy 101YP2500X

Record details

NPI number1447821145
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , LCAS-A , LCMHC-A
Sole proprietorNo
NPI enumeratedJuly 5, 2021
Last updated in NPPESJuly 6, 2023
Certification dateJuly 6, 2023

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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