Monique A. Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149005416 Issued in IL

Practice address

2656 W Montrose Ave
Chicago, IL 60618-1559

Phone

(773) 267-5795

Fax

(773) 267-4787

NPI assigned

Nov 6, 2013

Last updated

Nov 6, 2013By the provider in NPPES

Sex

Female

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mary and Tom Leo Associates, Inc.

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1174845291
  NPD (past)

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1053740373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W 102ND ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281915",
            "telephone_number": "773-416-1913",
            "fax_number": "773-468-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2656 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181559",
            "telephone_number": "773-267-5795",
            "fax_number": "773-267-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MONIQUE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149005416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melynda Smith, APRN
• Michael C Smith, RPH
• Michael C Smith, MD
• Michael David Smith, M.D.
• Molly M Smith, OTR/L
• Morgan Smith
• Nancy Allison Smith, MSW
• Natalie Diane Smith, LCSW
• Natasha Smith, MA, LCPC
• Nicolette Smith

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.