Individual provider Active NPI

Larry Jermaine Smith, LCSW, LMSW

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1073294005
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW24498 Issued in FL
Practice address
7821 N Dale Mabry Hwy Ste 208
Tampa, FL 33614-3200
Phone
(813) 443-4827
NPI assigned
Jul 31, 2023
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7585 CT
Clinical Social Worker 1041C0700X 18628 FL
Clinical Social Worker 1041C0700X SW24498 FL Primary

Addresses

Primary practice location

7821 N Dale Mabry Hwy Ste 208
Tampa, FL 33614-3200

Mailing address

19103 Cellini PL
Lutz, FL 33558-9009
Phone (813) 272-1954

Other practice location 1

19103 Cellini Pl
Lutz, FL 33558-9009
Phone (813) 272-1954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7585CTMDClinical Social Worker
18628FLMDClinical Social Worker
SW24498FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1073294005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19103 CELLINI PL",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335589009",
            "telephone_number": "813-272-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7821 N DALE MABRY HWY STE 208",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143200",
            "telephone_number": "813-443-4827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19103 Cellini Pl",
            "address_purpose": "LOCATION",
            "city": "Lutz",
            "state": "FL",
            "postal_code": "335589009",
            "country_code": "US",
            "telephone_number": "813-272-1954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LARRY",
        "middle_name": "JERMAINE",
        "name_prefix": "Mr.",
        "credential": "LCSW, LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "7585",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "18628",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.