Individual provider Active NPI

Alba D Perez Smith, LICSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1104597624
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW04393 Issued in RI
Practice address
383 W Fountain St
Providence, RI 02903-3515
Phone
(401) 400-1863
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW04393 RI Primary
Clinical Social Worker 1041C0700X 1140765 MA

Addresses

Primary practice location

383 W Fountain St
Providence, RI 02903-3515

Mailing address

383 W Fountain St
Providence, RI 02903-3515
Phone (401) 400-1863

Other names 1

  • Alba D Vargas Perez Former name

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

169 Madison Ave
New York, NY 10016-5101

215 Park Ave S
Floor 10
New York, NY 10003-1620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1140765MAMDClinical Social Worker
ISW04393RIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1104597624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 W FOUNTAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029033515",
            "telephone_number": "401-400-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 W FOUNTAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029033515",
            "telephone_number": "401-400-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ SMITH",
        "first_name": "ALBA",
        "middle_name": "D",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW04393",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1140765",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALBA",
            "last_name": "VARGAS PEREZ",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.