Individual provider Active NPI

Olivia Elizabeth Smith, LCSWA

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1073299376
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P019132 Issued in NC
Practice address
7850 Brier Creek Pkwy Ste 102
Raleigh, NC 27617-8900
Phone
(984) 263-0846
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X P019132 NC Primary

Addresses

Primary practice location

7850 Brier Creek Pkwy Ste 102
Raleigh, NC 27617-8900

Mailing address

4705 University Dr
Durham, NC 27707-3489
Phone (919) 237-1337

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
P019132NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA Single Specialty CurrentSince Jun 25, 2023 Accepting new patients
Allison Grubbs, LCSW, Lcas, PLLC Clinical Past Accepting new patients

Locations

4705 University Dr
Durham, NC 27707

7850 Brier Creek Pkwy
Ste 102
Raleigh, NC 27617
Phone (919) 748-4878

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1073299376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-237-1337",
            "fax_number": "919-237-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 BRIER CREEK PKWY STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276178900",
            "telephone_number": "984-263-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "OLIVIA",
        "middle_name": "ELIZABETH",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.