Active NPI
Carly Athanasatos
- Social Worker
- Port St Lucie, FL
National Provider Identifier
1679979819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 10570 S Federal Hwy
Swuite 200
Port St Lucie, FL 34952-5606 - Phone
- (772) 380-9972
- NPI assigned
- Nov 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | FL | Primary | |
| Developmental Therapist | 222Q00000X | FL |
Addresses
Primary practice location
10570 S Federal Hwy
Swuite 200
Port St Lucie, FL 34952-5606
Mailing address
10570 S Federal Hwy
Swuite 200
Port St Lucie, FL 34952-5606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416182400000",
"number": "1679979819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10570 S FEDERAL HWY",
"address_2": "SWUITE 200",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349525606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10570 S FEDERAL HWY",
"address_2": "SWUITE 200",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349525606",
"telephone_number": "772-380-9972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATHANASATOS",
"first_name": "CARLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-11-17",
"last_updated": "2014-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": null,
"primary": true
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "FL",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
- Fady Asslo, M.D.
- Associates in Infectious Diseases
- Associates in Medicine, LLC
- Kerry D Aston, DMD
- Michael Timothy Aston, DMD
- Atlantic Care Home Health West Palm Beach LLC
- Atlantic Coast Anesthesia Associates
- Atlantic Dental Management Company PA
- Atlantic Isles Inpatient Services,LLC.
- Atlantic Skin Surgery LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.