Individual provider Active NPI

Carly Weiss

  • Counselor
  • Sarasota, FL
National Provider Identifier
1437956570
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1125 Villagio Cir Unit 204
Sarasota, FL 34237-3640
Phone
(845) 531-7246
NPI assigned
Feb 26, 2025
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

1125 Villagio Cir Unit 204
Sarasota, FL 34237-3640

Mailing address

1125 Villagio Cir Unit 204
Sarasota, FL 34237-3640
Phone (845) 531-7246

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
I20250403000191 FL Practitioner - Clinical Social Worker 2062935711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Total Mind Care LLCGroup PAC ID 0648638734, 8 clinicians

Practice addresses (Care Compare)

2650 Bahia Vista St
Suite 204
Sarasota, FL 34239-2625
Phone (941) 202-1999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Total Mind Care, LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

2650 Bahia Vista St
Ste 204
Sarasota, FL 34239
Phone (941) 202-1999

Organizations & group practices 1

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": "1740528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1437956570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 VILLAGIO CIR UNIT 204",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342373640",
            "telephone_number": "845-531-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 VILLAGIO CIR UNIT 204",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342373640",
            "telephone_number": "845-531-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "CARLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.