Mary CHI Carlisle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW9443 Issued in FL

Practice address

16707 Windsor Park Dr
Lutz, FL 33549-6848

Phone

(813) 367-7733

NPI assigned

Jun 9, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary CHI Frank Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doctor on Demand Professionals P CGroup PAC ID 9436464567, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.carlisle.1@30520.direct.athenahealth.com

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.

• Doctor on Demand Professionals P C

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1174931448

  FL

  Medicare reassignment Care Compare group NPD
• Behavioral Health Management Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valrico, FL
  • NPI 1215403662
  NPD (past)

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1205062932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16707 WINDSOR PARK DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496848",
            "telephone_number": "813-367-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16707 WINDSOR PARK DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496848",
            "telephone_number": "813-367-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "MARY",
        "middle_name": "CHI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FRANK",
            "middle_name": "CHI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cardiovascular Clinic, Inc.
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• Caring Hearts & Hands Support Agency LLC
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• Douglas Adam Carmody, LCSW
• Viviana Carrasco Lima
• Kiara Marie Carror
• Eric Lane Khaled Carter, M.D.

• Clinical Social Worker in Lutz, FL
• Providers in Lutz, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.