Individual provider Active NPI

Emilly Marie Carter

  • Clinical Social Worker
  • Saltillo, MS
National Provider Identifier
1639034812
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
M11815 Issued in MS
Practice address
159 Willowbrook Dr
Saltillo, MS 38866-6896
Phone
(662) 760-5085
NPI assigned
Dec 18, 2025
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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 M11815 MS Primary

Addresses

Primary practice location

159 Willowbrook Dr
Saltillo, MS 38866-6896

Mailing address

89 Clayton Rd
Ecru, MS 38841-7720
Phone (662) 296-8226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
M11815MSMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1766016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1639034812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 CLAYTON RD",
            "city": "ECRU",
            "state": "MS",
            "postal_code": "388417720",
            "telephone_number": "662-296-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 WILLOWBROOK DR",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388666896",
            "telephone_number": "662-760-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "EMILLY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-18",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "M11815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saltillo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.