Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carolina Gentry, LICSW

Individual provider Clinical Social Worker · NPI 1700493137

Carolina Gentry, LICSW is a Clinical Social Worker in Saint Paul, Minnesota. Qualified in 2020, 6 years ago. Practices with Life on Purpose Counseling and Neurofeedback Inc, a 3-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2020
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone: (651) 602-7500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1700493137
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedSeptember 29, 2020
Last updated in NPPESSeptember 29, 2020
Certification dateSeptember 29, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Life On Purpose Counseling And Neurofeedback Inc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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