Active NPI
Lawrence Edward Smith, LCSW
- Clinical Social Worker
- Port Jervis, NY
National Provider Identifier
1033161963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R029100
- Practice address
- 15 Shin Hollow Rd
Port Jervis, NY 12771-3821 - Phone
- (845) 866-5542
- Fax
- (845) 858-3837
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R029100 | NY | Primary |
Addresses
Primary practice location
15 Shin Hollow Rd
Port Jervis, NY 12771-3821
Mailing address
15 Shin Hollow Rd
Port Jervis, NY 12771-3821
Phone (845) 866-5542
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
| License | State | Type | Specialty |
|---|---|---|---|
| R029100 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1033161963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 SHIN HOLLOW RD",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127713821",
"telephone_number": "845-866-5542",
"fax_number": "845-858-3837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 SHIN HOLLOW RD",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127713821",
"telephone_number": "845-866-5542",
"fax_number": "845-858-3837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "LAWRENCE",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R029100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jervis, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.