Carly Marie Riccio, LCSW

Key facts

NPI

1972444263

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

SW26250 (FL)

Practice address

4300 Bayou Blvd Ste 30
Pensacola, FL 32503-2671

Phone

(850) 420-9317

Fax

(850) 505-3078

NPI assigned

Apr 2, 2026

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• The Healing Impact, Inc Clinical Social Worker · Shalimar, FL · NPI 1154988772
  NPD CLINICAL

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 2, 2026.

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1972444263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 BAYOU BLVD STE 30",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032671",
            "telephone_number": "850-420-9317",
            "fax_number": "850-505-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 BAYOU BLVD STE 30",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032671",
            "telephone_number": "850-420-9317",
            "fax_number": "850-505-3078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 9th Ave Ste F",
            "address_purpose": "LOCATION",
            "city": "Shalimar",
            "state": "FL",
            "postal_code": "325791742",
            "country_code": "US",
            "telephone_number": "850-420-9317",
            "fax_number": "850-505-3078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4100 S Ferdon Blvd Ste B4",
            "address_purpose": "LOCATION",
            "city": "Crestview",
            "state": "FL",
            "postal_code": "325365287",
            "country_code": "US",
            "telephone_number": "850-420-9317",
            "fax_number": "850-505-3078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICCIO",
        "first_name": "CARLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW26250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Pensacola, FL · Clinical Social Worker in Florida