Active NPI
Debra Michele Davis-Smith, LCSW
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1104128230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R034505-1
- Practice address
- 760 Broadway
Room# 5a-06
Brooklyn, NY 11206-5317 - Phone
- (718) 963-5863
- NPI assigned
- Nov 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R034505-1 | NY | Primary |
Addresses
Primary practice location
760 Broadway
Room# 5a-06
Brooklyn, NY 11206-5317
Mailing address
760 Broadway
Room# 5a-06
Brooklyn, NY 11206
Phone (718) 963-5863
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034505 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290384000000",
"number": "1104128230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 BROADWAY",
"address_2": "ROOM# 5A-06",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11206",
"telephone_number": "718-963-5863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 BROADWAY",
"address_2": "ROOM# 5A-06",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112065317",
"telephone_number": "718-963-5863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS-SMITH",
"first_name": "DEBRA",
"middle_name": "MICHELE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-22",
"last_updated": "2010-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R034505-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; 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.