Kerry Lynn Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004428 Issued in CT

Practice address

37 River Rd
Deep River, CT 06417-2117

Phone

(860) 391-3647

Fax

(860) 388-9656

NPI assigned

Feb 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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 1

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Riverstone Counseling LLC

  • Clinical Social Worker
  • Deep River, CT
  • NPI 1689568396

  Clinical, CT

  Medicare reassignment NPD Authorized official
• Project Courage, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Old Saybrook, CT
  • NPI 1659716405
  NPD (past)

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

{
    "created_epoch": "1519430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1043711039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 RIVER RD",
            "city": "DEEP RIVER",
            "state": "CT",
            "postal_code": "064172117",
            "telephone_number": "860-391-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 RIVER RD",
            "city": "DEEP RIVER",
            "state": "CT",
            "postal_code": "064172117",
            "telephone_number": "860-391-3647",
            "fax_number": "860-388-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KERRY",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-24",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DeepRiver",
            "affiliation": "N",
            "address_1": "37 River Rd",
            "city": "Deep River",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064172117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Regional School District #4
• Riverstone Counseling LLC
• Megan Schwartz, PHARMD
• Corrine Lake Sieser
• Rebecca Slevin
• Town of Deep River
• Tri-Town Youth Services Bureau, Inc.
• Howard Tunick, DDS
• Walgreen Co

• Clinical Social Worker in Deep River, CT
• Providers in Deep River, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.