Individual provider Active NPI

Eustachian Koreen Carrier, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1922865120
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW26155 Issued in FL
Practice address
4300 Marsh Landing Blvd Ste 101
Jacksonville, FL 32250-1419
Phone
(850) 296-1209
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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 SW26155 FL Primary

Addresses

Primary practice location

4300 Marsh Landing Blvd Ste 101
Jacksonville, FL 32250-1419

Mailing address

4300 Marsh Landing Blvd Ste 101
Jacksonville Beach, FL 32250-1419
Phone (904) 686-8055

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
I20260319000401 FL Practitioner - Clinical Social Worker 8325522253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4300 Marsh Landing Blvd
Suite 101
Jacksonville Beach, FL 32250-1419
Phone (833) 362-7935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW26155FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita Springs Retirement Village, Inc. CurrentSince Mar 10, 2026 Accepting new patients

Locations

2055 Reyko Rd
Ste 100
Jacksonville, FL 32207
Phone (904) 648-8200

4300 Marsh Landing Blvd
Ste 101
Jacksonville Beach, FL 32250
Phone (904) 686-2690

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1922865120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MARSH LANDING BLVD STE 101",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322501419",
            "telephone_number": "904-686-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARSH LANDING BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501419",
            "telephone_number": "850-296-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIER",
        "first_name": "EUSTACHIAN",
        "middle_name": "KOREEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW26155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.