Individual provider Active NPI

Carrie Richardson, LCSW

  • Clinical Social Worker
  • Boone, NC
National Provider Identifier
1497010011
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009390 Issued in NC
Practice address
950 State Farm Rd BLDG 2ND
Boone, NC 28607-5021
Phone
(828) 268-9454
Fax
(828) 268-9458
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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 C009390 NC Primary

Addresses

Primary practice location

950 State Farm Rd BLDG 2ND
Boone, NC 28607-5021

Mailing address

950 State Farm Rd BLDG 2ND
Boone, NC 28607-5021
Phone (828) 268-9454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL, TX3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20151013001359 NC Practitioner - Clinical Social Worker 7719296797 Reassigns benefits to 3 organizations
I20250207000102 FL Practitioner - Clinical Social Worker 7719296797 Reassigns benefits to 1 organization
I20250317000369 TX Practitioner - Clinical Social Worker 7719296797 Reassigns benefits to 1 organization

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)

3511 Shannon Rd
Durham, NC 27707-6330
Phone (201) 293-7689

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
C009390NCMDClinical Social Worker
115414TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Medical Center Inc CurrentSince Jul 20, 2015 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Sep 20, 2023 Accepting new patients
Charles a Cannon Jr Memorial Hospital Inc CurrentSince Jul 20, 2015 Accepting new patients
Watauga Medical Center, Inc. CurrentSince Jul 20, 2015 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Past Accepting new patients
Charles a Cannon Jr Memorial Hospital Inc. Past Accepting new patients
Watauga Medical Center Inc Past Accepting new patients

Locations

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

155 Furman Rd
Ste 101
Boone, NC 28607
Phone (828) 262-4111

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

950 State Farm Rd
Bldg 2ND
Boone, NC 28607
Phone (828) 263-0121

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

3753 Howard Hughes Pkwy
Ste 200
Las Vegas, NV 89169
Phone (702) 919-6580

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1497010011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 STATE FARM RD BLDG 2ND",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075021",
            "telephone_number": "828-268-9454",
            "fax_number": "828-268-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 STATE FARM RD BLDG 2ND",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075021",
            "telephone_number": "828-268-9454",
            "fax_number": "828-268-9458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "CARRIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

Verify at the official NPI Registry.