Active NPI
Desiree Smith, CSW
- Social Worker
- Springfield, MA
National Provider Identifier
1104120765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 7699130-3502
- Practice address
- 130 Maple St
Springfield, MA 01103-2202 - Phone
- (413) 737-9544
- NPI assigned
- Dec 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7699130-3502 | UT | Primary |
Addresses
Primary practice location
130 Maple St
Springfield, MA 01103-2202
Mailing address
130 Maple St
Springfield, MA 01103-2202
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 876000308007 | Medicaid | UT | |
| 260022408 | Other | UT | RAILROAD MEDICARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7699130-3502 | UT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1104120765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 MAPLE ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011032202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 MAPLE ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011032202",
"telephone_number": "413-737-9544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DESIREE",
"credential": "CSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-22",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "7699130-3502",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "876000308007",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "260022408",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.