Jacqueline Ann Smith, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801073692 Issued in MI

Practice address

515 E 11 Mile Rd
Madison Heights, MI 48071-3701

Phone

(248) 548-4044

Fax

(248) 548-9239

NPI assigned

Feb 27, 2007

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1073640926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 COLUMBIA RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721916",
            "telephone_number": "248-548-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E 11 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713701",
            "telephone_number": "248-548-4044",
            "fax_number": "248-548-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801073692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smart Move Physical Therapy LLC
• Tracy L. Smiles, M.P.T.
• Brianna J Smith, PA-C
• Dominique Marielle Smith, BA-HIS
• Eric Smith, DDS
• Kay Smith
• Mackenzie Smith, MA CCC-SLP
• Alana Snyder, DO
• Solace You Therapy PLLC
• Nicholas Solu, DPT

• Clinical Social Worker in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.