Active Wellness Group LLC – Clinical Social Worker

Key facts

NPI: 1336737675
Entity type: Organization (NPI type 2)
Primary specialty: Clinical Social Worker 1041C0700X
Legal business name: ACTIVE WELLNESS GROUP LLC
Practice address: 605 S Main St
Trenton, FL 32693-3236
Phone: (386) 961-9616
NPI assigned: Jan 4, 2021
Organization subpart: No

Authorized official

Name: Kimberly Carpenter Herring, LCSW
Title: Owner
Phone: (386) 397-0696

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Ashley B Watson, LCSW Clinical Social Worker · Chiefland, FL · NPI 1649789645

Medicare reassignment NPD CLINICAL · FL
Crystal Riviere, LCSW Clinical Social Worker · Middleburg, FL · NPI 1730043498

Medicare reassignment FL
Kimberly Carpenter Herring, M.S.W., L.C.S.W. Clinical Social Worker · Trenton, FL · NPI 1508170838

NPD CLINICAL

Medicare participation

Medicare fee-for-service enrollment: Enrolled in FL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20260616004580	FL	Part B Supplier - Clinic/Group Practice	8325510787	Receives reassigned benefits from 2 practitioners Practice locations: Trenton, FL; Lake City, FL

National Provider Directory

Locations

871 SW State Road 47
Lake City, FL 32025
Phone (386) 961-9616

605 S Main St
Trenton, FL 32693
Phone (386) 961-9616

216 N Main St
Ste C
Trenton, FL 32693
Phone (352) 213-5185

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor Group: 193200000X MULTI-SPECIALTY GROUP	101YM0800X
Clinical Social Worker Group: 193200000X MULTI-SPECIALTY GROUP	1041C0700X			Yes

Addresses

Primary practice location

605 S Main St
Trenton, FL 32693-3236

Mailing address

605 S Main St
Trenton, FL 32693-3236
Phone (386) 961-9616

Other practice location 1

871 SW State Road 47
Lake City, FL 32025-0433
Phone (386) 961-9616

Other providers in Trenton, FL

All providers in Trenton, FL · Clinical Social Worker in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.