Individual provider Active NPI

Carly Elizabeth Snyder, MSW, LCSW

  • Clinical Social Worker
  • Pensacola, FL
National Provider Identifier
1780237982
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW19236 Issued in FL
Practice address
112 W Cervantes St
Pensacola, FL 32501-3128
Phone
(850) 261-3822
NPI assigned
Jul 17, 2019
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW19236 FL Primary
Clinical Social Worker 1041C0700X ISW13755 FL

Addresses

Primary practice location

112 W Cervantes St
Pensacola, FL 32501-3128

Mailing address

112 W Cervantes St
Pensacola, FL 32501-3128
Phone (850) 261-3822

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
I20231222000958 FL Practitioner - Clinical Social Worker 1951751569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adult and Child Mental Health CareGroup PAC ID 3173702859, 6 clinicians

Practice addresses (Care Compare)

112 W Cervantes St
Pensacola, FL 32501-3128
Phone (850) 466-3128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW13755FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adult & Child Mental Health Care Clinical CurrentSince Nov 20, 2023 Accepting new patients

Locations

112 W Cervantes St
Pensacola, FL 32501
Phone (850) 466-3128

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1780237982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W CERVANTES ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013128",
            "telephone_number": "850-261-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W CERVANTES ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013128",
            "telephone_number": "850-261-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "CARLY",
        "middle_name": "ELIZABETH",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19236",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW13755",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.