Individual provider Active NPI

Shavarne Carter, LMHC

  • Mental Health Counselor
  • Daytona Beach, FL
National Provider Identifier
1417636135
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
702 S Ridgewood Ave
Daytona Beach, FL 32114-5332
Phone
(800) 539-4228
NPI assigned
Jul 12, 2023
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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 Primary

Addresses

Primary practice location

702 S Ridgewood Ave
Daytona Beach, FL 32114-5332

Mailing address

150 Magnolia Ave
Daytona Beach, FL 32114-4304
Phone (386) 236-3215

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
I20240118000371 FL Practitioner - Mental Health Counselor 0547612210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sma Healthcare IncGroup PAC ID 0244226363, 39 clinicians

Practice addresses (Care Compare)

702 S Ridgewood Ave
Daytona Beach, FL 32114-5332
Phone (800) 539-4228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince May 14, 2024 Accepting new patients
Sma Healthcare, Inc CurrentSince Jan 1, 2024 Accepting new patients
Sma Healthcare Inc Current Accepting new patients
Sma Healthcare Inc Past Accepting new patients

Locations

301 Justice Ln
Bunnell, FL 32110
Phone (386) 236-1726

1150 Red John Dr
Daytona Beach, FL 32124
Phone (386) 236-3183

1220 Willis Ave
Daytona Beach, FL 32114
Phone (386) 236-3200

150 Magnolia Ave
Daytona Beach, FL 32114
Phone (386) 236-3215

3875 Tiger Bay Rd
Daytona Beach, FL 32124
Phone (386) 236-3234

702 S Ridgewood Ave
Daytona Beach, FL 32114
Phone (386) 254-1202

356 Englenook Dr
Ste 142
Debary, FL 32713

105 W Calvin St
Deland, FL 32720
Phone (386) 254-1104

1251 N Stone St
Deland, FL 32720
Phone (386) 469-1544

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

330 Kay Larkin Dr
Palatka, FL 32177
Phone (386) 329-3780

1880 San Sebastian Vw
Ste 4201
St Augustine, FL 32084

Interoperability endpoints

  • Direct secure messaging: shavarne.carter.p1@direct.smahealthcare.nextgenshare.com

Organizations & group practices 4

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": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1417636135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MAGNOLIA AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144304",
            "telephone_number": "386-236-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S RIDGEWOOD AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145332",
            "telephone_number": "800-539-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "SHAVARNE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.