Kelly Anne Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9759-C Issued in AR

Practice address

101 W Walnut St Ste C
Rogers, AR 72756-6662

Phone

(435) 420-4207

NPI assigned

Dec 3, 2012

Sex

Female

Sole proprietor

No

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

Enrolled in AR

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nurture Wellness Therapy and Yoga, LLC

  • Adult Mental Health Clinic/Center
  • Bentonville, AR
  • NPI 1902648454
  Medicare reassignment NPD Authorized official
• Reflections Counseling and Play Therapy Inc

  • Mental Health Counselor
  • Rogers, AR
  • NPI 1336907989
  NPD (past)
• Inmindout Emotional Wellness Center, LLC

  • Psychologist
  • New Braunfels, TX
  • NPI 1457799330
  NPD (past)

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1063757052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W WALNUT ST STE C",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727566662",
            "telephone_number": "435-420-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W WALNUT ST STE C",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727566662",
            "telephone_number": "435-420-4207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "9759-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haylie R Smith
• Jacob Oliver Smith, D.D.S.
• James W Smith, DO
• Jeremy Smith, DDS
• Kathryn H. Smith, CRNA
• Lisa Marie Smith, PHARMD
• Luke Hall Smith, M.D.
• Madeline Leigh Smith, OTR/L
• Melanie Anne Smith
• Winifer Collins Smith, RN

• Clinical Social Worker in Rogers, AR
• Providers in Rogers, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.