Individual provider Active NPI

Tanya Carrillo, LCSW

  • Clinical Social Worker
  • Naples, FL
National Provider Identifier
1720955370
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW25394 Issued in FL
Practice address
12655 Collier Blvd
Naples, FL 34116-4005
Phone
(239) 658-3000
Fax
(239) 658-3052
NPI assigned
Oct 20, 2025
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 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 SW25394 FL Primary

Addresses

Primary practice location

12655 Collier Blvd
Naples, FL 34116-4005

Mailing address

544 El Paso TRL
Immokalee, FL 34142-4603
Phone (239) 658-3000

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
I20251122000205 FL Practitioner - Clinical Social Worker 1456843978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of South Florida College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1454 Madison Ave W
Immokalee, FL 34142-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW25394FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Collier Health Services, Inc CurrentSince Nov 17, 2025 Accepting new patients
Collier Health Services Inc CurrentSince Nov 17, 2025 Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients

Locations

1454 Madison Ave W
Immokalee, FL 34142
Phone (239) 658-3064

12655 Collier Blvd
Naples, FL 34116
Phone (239) 571-9015

Interoperability endpoints

  • Direct secure messaging: tanya.carrillo.1@10865.direct.athenahealth.com

Organizations & group practices 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1720955370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 EL PASO TRL",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341424603",
            "telephone_number": "239-658-3000",
            "fax_number": "239-658-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 COLLIER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341164005",
            "telephone_number": "239-658-3000",
            "fax_number": "239-658-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "TANYA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW25394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.