Individual provider Active NPI

Cody Smith, LCSW-BACS

  • Clinical Social Worker
  • New Orleans, LA
National Provider Identifier
1053966861
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12593 Issued in LA
Practice address
1631 Elysian Fields Ave
New Orleans, LA 70117-8208
Phone
(504) 821-2601
Fax
(888) 736-9806
NPI assigned
Aug 8, 2019
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12593 LA Primary

Addresses

Primary practice location

1631 Elysian Fields Ave
New Orleans, LA 70117-8208

Mailing address

729 Cedar Ave
Metairie, LA 70001-4601
Phone (504) 355-1740

Other practice location 1

729 Cedar Ave
Metairie, LA 70001-4601
Phone (504) 355-1740

Other practice location 2

2515 Canal St
New Orleans, LA 70119-6435
Phone (504) 821-2601

Other identifiers 1

IdentifierTypeStateIssuer
2507265MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20240301003122 LA Practitioner - Clinical Social Worker 4688019417 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
No AIDS Task Force CurrentSince Jan 17, 2024 Accepting new patients
No AIDS Task Force CurrentSince Jan 17, 2024 Accepting new patients

Locations

1631 Elysian Fields Ave
New Orleans, LA 70117
Phone (504) 821-2601

2515 Canal St
New Orleans, LA 70119
Phone (504) 821-2601

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1053966861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 CEDAR AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700014601",
            "telephone_number": "504-355-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 ELYSIAN FIELDS AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701178208",
            "telephone_number": "504-821-2601",
            "fax_number": "888-736-9806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "729 Cedar Ave",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "700014601",
            "country_code": "US",
            "telephone_number": "504-355-1740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2515 Canal St",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701196435",
            "country_code": "US",
            "telephone_number": "504-821-2601",
            "fax_number": "888-736-9806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CODY",
        "credential": "LCSW-BACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-08",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "12593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2507265",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.