John Winston Smith Jr., LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P010695 Issued in NC

Practice address

118 New Stateside Dr
Chapel Hill, NC 27516-1165

Phone

(919) 942-1840

NPI assigned

Oct 17, 2016

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

• Freedom House Recovery Center, Inc.

  • Community/Behavioral Health Agency
  • Chapel Hill, NC
  • NPI 1548490378
  NPD (past)
• Freedom House Recovery Center, Inc.

  • Community/Behavioral Health Agency
  • Chapel Hill, NC
  • NPI 1609047158
  NPD (past)

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1063963940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 NEW STATESIDE DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275161165",
            "telephone_number": "919-942-2126",
            "fax_number": "919-942-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NEW STATESIDE DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275161165",
            "telephone_number": "919-942-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "WINSTON",
        "name_suffix": "Jr.",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Nicole Smith, M.D.
• Javier Rajae Smith
• Jeffrey Smith, MD
• Jennifer Nicole Smith, PHARMD
• Jeremy Keith Smith, M.D.
• Jonathan Smith
• Katelynn Smith, MD
• Kathleen A Smith, M.D.
• Kathleen Fitzpatrick Smith
• Kelly Lacy Smith, M.D.

• Clinical Social Worker in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.