Individual provider Active NPI

Carolyn Patricia Hallinan

  • Clinical Social Worker
  • Vero Beach, FL
National Provider Identifier
1093469223
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10330 Issued in FL
Practice address
400 Union St
Vero Beach, FL 32966-8731
Phone
(863) 370-2728
NPI assigned
Feb 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW10330 FL Primary

Addresses

Primary practice location

400 Union St
Vero Beach, FL 32966-8731

Mailing address

400 Union St
Vero Beach, FL 32966-8731
Phone (863) 370-2728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220228002360 FL Practitioner - Clinical Social Worker 6002087541 Reassigns benefits to 1 organization
I20230607001725 NC Practitioner - Clinical Social Worker 6002087541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Direct Access Counseling and Supportive Services LLCGroup PAC ID 3971878398, 11 clinicians

Practice addresses (Care Compare)

223 E Oak St
Apt 3
Arcadia, FL 34266-4445
Phone (239) 652-0260

330 21St St SE
Hickory, NC 28602-4427
Phone (704) 800-5906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW10330FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Access Counseling & Supportive Services, LLC Clinical CurrentSince Feb 24, 2022 Accepting new patients
Ultima Rehab-FL LLC PastSince May 29, 2019 Accepting new patients

Locations

390 Pondella Rd
Ste 9
North Ft Myers, FL 33903
Phone (239) 652-0260

330 21st St SE
Hickory, NC 28602
Phone (239) 652-0260

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1093469223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 UNION ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329668731",
            "telephone_number": "863-370-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 UNION ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329668731",
            "telephone_number": "863-370-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLINAN",
        "first_name": "CAROLYN",
        "middle_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.