Carroll Paul Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C0876 Issued in MS

Practice address

720 Avignon Dr
Suite 3
Ridgeland, MS 39157-5166

Phone

(601) 259-6714

Fax

(601) 605-2710

NPI assigned

Apr 4, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1013206606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 DUBLIN CT",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390478035",
            "telephone_number": "601-259-6714",
            "fax_number": "601-605-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 AVIGNON DR",
            "address_2": "SUITE 3",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575166",
            "telephone_number": "601-259-6714",
            "fax_number": "601-605-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARROLL",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C0876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe H Smelser, PT
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• Smile Straight Orthodontics-Central Ms PLLC
• Ashley Smith, LPC
• Bridget Smith, DPT
• Chelsea Lynn Smith, BCBA, LBA
• Cherish Smith
• Hanna Ruth Smith
• Jamila Smith, LPTA
• Jena Naomi Smith, NP-C

• Clinical Social Worker in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.