Individual provider Active NPI

Carrie A Sommer, MSW, LCSW

  • Clinical Social Worker
  • South Bend, IN
National Provider Identifier
1093884579
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004645A Issued in IN
Practice address
108 N Main St Ste 200
South Bend, IN 46601-1613
Phone
(574) 234-3515
Fax
(574) 235-3565
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 34004645A IN
Clinical Social Worker 1041C0700X 34004645A IN Primary

Addresses

Primary practice location

108 N Main St Ste 200
South Bend, IN 46601-1613

Mailing address

108 N Main St
South Bend, IN 46601-1625
Phone (574) 234-3515

Other identifiers 2

IdentifierTypeStateIssuer
000000538677OtherINUNICARE
000000538677OtherINANTHEM

Other names 1

  • Ms. Carrie A Horvath Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090123000531 IN Practitioner - Clinical Social Worker 8628132313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

57340 Alpha Dr
Goshen, IN 46528-7808
Phone (574) 370-1381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34004645AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carrie Sommer Counseling LLC Clinical CurrentSince Jan 27, 2020 Accepting new patients
Intrigue Counseling Past Accepting new patients
Intrigue Counseling, Inc Clinical Past Accepting new patients

Locations

57340 Alpha Dr
Goshen, IN 46528
Phone (574) 293-0005

Organizations & group practices 3

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303776000000",
    "number": "1093884579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N MAIN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011625",
            "telephone_number": "574-234-3515",
            "fax_number": "574-234-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N MAIN ST STE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011613",
            "telephone_number": "574-234-3515",
            "fax_number": "574-235-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMER",
        "first_name": "CARRIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2011-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "34004645A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004645A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "000000538677",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000538677",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "HORVATH",
            "middle_name": "A",
            "prefix": "MS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.