Erickson T Smith, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

002619 Issued in MO

Practice address

5920 Dr Martin Luther King Dr
Saint Louis, MO 63112-3516

Phone

(314) 389-5737

Fax

(314) 382-1660

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Hi - Tech Charities

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1528792660

  Clinical

  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1003938754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 DR MARTIN LUTHER KING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123516",
            "telephone_number": "314-922-7139",
            "fax_number": "314-382-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 DR MARTIN LUTHER KING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123516",
            "telephone_number": "314-389-5737",
            "fax_number": "314-382-1660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Hickory Street",
            "address_purpose": "LOCATION",
            "city": "Irondale",
            "state": "MO",
            "postal_code": "636489998",
            "country_code": "US",
            "telephone_number": "573-749-0260",
            "fax_number": "573-749-0246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ERICKSON",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "002619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493542419",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Gloss Smith, CRNA
• Ellen Smith
• Emily Hoffman Smith, M.D.
• Emily L Smith, MD
• Eral Nicole Smith, LPN
• Erin Mae Smith, LPC
• Floyd P Smith, LCSW
• Gina Smith
• Gladys A Smith, LPC,CCMHC
• Grace M Smith, PLPC

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.