Carolyn Eddy, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

108370 Issued in CA

Practice address

924 Emerald Bay Rd # A2
South Lake Tahoe, CA 96150-9405

Phone

(907) 220-4729

NPI assigned

Feb 22, 2007

Last updated

Dec 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/eef7bdb7-cd7b-4ec1-b846-cf9ec1db80c8/

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.

• Barton Medical Foundation

  • Family Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1750950499
  Medicare reassignment Care Compare group NPD
• Sierra Child & Family Services

  • Community/Behavioral Health Agency
  • South Lake Tahoe, CA
  • NPI 1932527330
  NPD
• Changing Tides Family Services

  • Community/Behavioral Health Agency
  • Eureka, CA
  • NPI 1336453505
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1578698247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 EMERALD BAY RD # A2",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961509405",
            "telephone_number": "907-220-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 EMERALD BAY RD # A2",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961509405",
            "telephone_number": "907-220-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDY",
        "first_name": "CAROLYN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy R Durkin, D.D.S.
• Dustin Kieschnick, PSYD
• Justin Eastman
• Eat Beyond Labels Inc
• Celeste Marie Eckerman, DDS
• Jessica Eddy
• Nicholas James Edge
• Leslie Edmonds
• Jennifer Ann Ehmann, MD
• John Tyler Eichenberger, FNP

• Clinical Social Worker in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.