Individual provider Active NPI

Carolyn Redmond, LCSW

  • Clinical Social Worker
  • St Petersburg, FL
National Provider Identifier
1376802520
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14700 Issued in FL
Practice address
3251 3Rd Ave N
St Petersburg, FL 33713-8506
Phone
(727) 321-3854
Fax
(727) 327-7670
NPI assigned
May 9, 2012
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW14700 FL Primary

Addresses

Primary practice location

3251 3Rd Ave N
St Petersburg, FL 33713-8506

Mailing address

3251 3Rd Ave N
St Petersburg, FL 33713-8506
Phone (727) 321-3854

Other practice location 1

2020 26th Ave E
Bradenton, FL 34208-7753
Phone (941) 782-4600

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170922003325 FL Practitioner - Clinical Social Worker 8426322892 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14700FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Holistic Therapy Group LLC Clinical CurrentSince Sep 15, 2021 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Jan 10, 2025 Accepting new patients
Divine Empowerment, LLC Clinical CurrentSince Feb 9, 2025 Accepting new patients
Diversity Health Services Inc Clinical CurrentSince Feb 1, 2022 Accepting new patients

Locations

911 S Parsons Ave
Ste F
Brandon, FL 33511
Phone (813) 808-4089

10668 New East Bay Rd
Gibsonton, FL 33534
Phone (813) 405-4137

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

15310 Amberly Dr
Ste 250
Tampa, FL 33647
Phone (813) 530-5257

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1376802520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3251 3RD AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138506",
            "telephone_number": "727-321-3854",
            "fax_number": "727-327-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 3RD AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138506",
            "telephone_number": "727-321-3854",
            "fax_number": "727-327-7670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 26th Ave E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342087753",
            "country_code": "US",
            "telephone_number": "941-782-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDMOND",
        "first_name": "CAROLYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.