Individual provider Active NPI

William H. Smith, MSW, ACSW, LISW, LCS

  • Clinical Social Worker
  • Willoughby Hills, OH
National Provider Identifier
1043274764
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0003609 Issued in OH
Practice address
34900 Chardon Rd Ste 200
Willoughby Hills, OH 44094-9161
Phone
(216) 468-5000
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 3609 OH
Clinical Social Worker 1041C0700X SW 9067 FL
Clinical Social Worker 1041C0700X I.0003609 OH Primary

Addresses

Primary practice location

34900 Chardon Rd Ste 200
Willoughby Hills, OH 44094-9161

Mailing address

34900 Chardon Rd
Ste 200
Willoughby Hills, OH 44094-9161
Phone (440) 957-5600

Other practice location 1

1210 W Del Webb Blvd
Sun City Center, FL 33573-5224
Phone (813) 347-4462 ext. 222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040513000940 OH Practitioner - Clinical Social Worker 0042200966 Reassigns benefits to 1 organization
Practice locations: Euclid, OH
I20151109000799 FL Practitioner - Clinical Social Worker 0042200966 Practice locations: Sun City Center, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

25101 Chagrin Blvd
Suite 100
Beachwood, OH 44122-5694
Phone (216) 831-6611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3609OHMDSocial Worker
SW 9067FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Nov 15, 2022 Accepting new patients

Locations

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

34900 Chardon Rd
Ste 200
Willoughby Hills, OH 44094
Phone (440) 951-5600

Organizations & group practices 1

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1043274764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34900 CHARDON RD",
            "address_2": "STE 200",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949161",
            "telephone_number": "440-957-5600",
            "fax_number": "440-957-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34900 CHARDON RD STE 200",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949161",
            "telephone_number": "216-468-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1210 W Del Webb Blvd",
            "address_purpose": "LOCATION",
            "city": "Sun City Center",
            "state": "FL",
            "postal_code": "335735224",
            "country_code": "US",
            "telephone_number": "813-347-4462 x222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILLIAM",
        "middle_name": "H.",
        "credential": "MSW, ACSW, LISW, LCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "3609",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 9067",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0003609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby Hills, OH

Sources for this page

Verify at the official NPI Registry.