Deborra Marie Smith, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

00732 Issued in IA

Practice address

1307 Sunnyside LN
Atlantic, IA 50022-2205

Phone

(712) 243-1213

Fax

(712) 243-4675

NPI assigned

Dec 2, 2006

Last updated

Jan 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therapy Place, Inc.

  • Clinical Social Worker
  • Atlantic, IA
  • NPI 1194886028
  Medicare reassignment NPD

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1093883431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 1800TH ST",
            "address_2": "P.O. BOX #1",
            "city": "PANAMA",
            "state": "IA",
            "postal_code": "515626104",
            "telephone_number": "712-489-2824",
            "fax_number": "712-243-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 SUNNYSIDE LN",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500222205",
            "telephone_number": "712-243-1213",
            "fax_number": "712-243-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DEBORRA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-02",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "00732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0220301",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor J Schroeder, D.D.S.
• Samantha Rose Schuster, PA-C
• Robert H Sharp, O.D.
• Lace Sindt, DNP
• Amanda J Smith, TCADC
• Elizabeth Smith
• Jacalyn Sue Smith
• Ruth Smith, RPT
• Southwest Iowa Mental Health Center
• Southwest Iowa Planning Council

• Clinical Social Worker in Atlantic, IA
• Providers in Atlantic, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.