Individual provider Active NPI

Evalee Paige Smith, LCSW

  • Clinical Social Worker
  • Savannah, GA
National Provider Identifier
1003118522
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004128 Issued in GA
Practice address
110 W 76TH St
Savannah, GA 31405-6808
Phone
(912) 655-5002
NPI assigned
Dec 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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 CSW004128 GA Primary

Addresses

Primary practice location

110 W 76TH St
Savannah, GA 31405-6808

Mailing address

110 W 76TH St
Savannah, GA 31405-6808
Phone (912) 655-5002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW004128GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Online Counseling and Group Therapy, LLC CurrentSince Oct 11, 2020 Accepting new patients
Aspire Therapy Services LLC PastSince Mar 9, 2020 Accepting new patients

Locations

61 Riverwalk Blvd
Ste H
Ridgeland, SC 29936
Phone (843) 636-5017

Networks

  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3

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": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1003118522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 76TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056808",
            "telephone_number": "912-655-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W 76TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056808",
            "telephone_number": "912-655-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EVALEE",
        "middle_name": "PAIGE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.