Carissa A Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12921 Issued in FL

Practice address

6847 N 9TH Ave Ste A145
Pensacola, FL 32504-7396

Phone

(813) 420-4456

Fax

(850) 595-1400

NPI assigned

Jul 8, 2014

Last updated

Oct 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, CO2 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

Specialty

Clinical Social Worker

Education

University of South Florida College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1316353642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6847 N 9TH AVE STE A145",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047396",
            "telephone_number": "813-420-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6847 N 9TH AVE STE A145",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047396",
            "telephone_number": "813-420-4456",
            "fax_number": "850-595-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 E Harmony Rd Unit A56",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805258891",
            "country_code": "US",
            "telephone_number": "813-420-4456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARISSA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW09930761",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012372100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Elaine Smith, PNP
• Ashlynn Smith, LCSW
• Bradley Howard Smith, M.D.
• Brian Jeffrey Smith, A.T.,C
• Brooke Smith, RBT
• Cayden Smith
• Chad Smith, CRNA
• Christina L Smith, CRNA
• Christopher Shane Smith, PA-C
• David Michael Smith III, DO

• Clinical Social Worker in Pensacola, FL
• Providers in Pensacola, 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 Oct 8, 2024; 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.