CARRIE PERNESKY (LMSW) – Social Worker, NPI 1164855946

CARRIE PERNESKY (LMSW) is a healthcare provider. based in Holland, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801106124 (MI). The NPI Number for CARRIE PERNESKY (LMSW) is 1164855946

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
CARRIE PERNESKY (LMSW)
NPI
1164855946
Phone
(616) 393-5600
Address
12265 JAMES ST
Enumeration Date
15 August 2013
Last Update Date
15 April 2020

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Secondary Phone
6163935641
Graduation Year
2012 (14 years ago)
PAC ID
4183140635
Group Practice PAC ID
0042118036
Professional Enrollment ID
I20250428002293
Address ID
MI494248613HO12265STXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

4,887 CLINICAL SOCIAL WORKER in MI

Provider Addresses for CARRIE PERNESKY (LMSW)

  • 12265 JAMES ST

    HOLLAND, MI 494248613

    Phone: (616) 393-5600

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-28

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250428002293IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49424)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042118036View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical Social WorkerMI
-MI
-MI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Nurse PractitionerMI
Clinical Social WorkerMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

How do payers reference CARRIE PERNESKY (LMSW)?
For CARRIE PERNESKY (LMSW), use NPI 1164855946 as the unique 10-digit identifier.
Would CARRIE PERNESKY (LMSW) appear as active to a payer?
You can treat CARRIE PERNESKY (LMSW) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with CARRIE PERNESKY (LMSW)?
CARRIE PERNESKY (LMSW)'s record emphasizes Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for CARRIE PERNESKY (LMSW)?
Travel planning: use Holland, Michigan as the reference point for CARRIE PERNESKY (LMSW), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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