Individual provider Active NPI

Carrie Simmons, LMHC

  • Mental Health Counselor
  • St Petersburg, FL
National Provider Identifier
1104294578
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 13172 Issued in FL
Practice address
275 96TH Ave N
Suite 3
St Petersburg, FL 33702-2504
Phone
(727) 579-0080
NPI assigned
Sep 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 13172 FL Primary

Addresses

Primary practice location

275 96TH Ave N
Suite 3
St Petersburg, FL 33702-2504

Mailing address

275 96TH Ave N
Suite 3
St Petersburg, FL 33702-2504
Phone (727) 579-0080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY, TN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20240703000184 FL Practitioner - Mental Health Counselor 6507300423 Reassigns benefits to 1 organization
I20250625002565 NY Practitioner - Mental Health Counselor 6507300423 Reassigns benefits to 1 organization
I20251227000512 TN Practitioner - Mental Health Counselor 6507300423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2578 Broadway
Suite 607
New York, NY 10025-7869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH 13172FLMDMental Health Counselor
7854TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Talkspace Medical Services Ny PC CurrentSince Apr 21, 2025 Accepting new patients
Talkspace Provider Network PA CurrentSince Apr 21, 2024 Accepting new patients

Locations

2578 Broadway
#607
New York, NY 10025
Phone (516) 847-5432

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

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": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1104294578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 96TH AVE N",
            "address_2": "SUITE 3",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022504",
            "telephone_number": "727-579-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 96TH AVE N",
            "address_2": "SUITE 3",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022504",
            "telephone_number": "727-579-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "CARRIE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 13172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.