Grace Kimburi Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008449 Issued in NC

Practice address

7895 Waterway Dr NW Apt 306
Concord, NC 28027-4436

Phone

(828) 808-4397

NPI assigned

Jan 24, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, SC, FL3 enrollments

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 3

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 and National Provider Directory roles.

• MCCD FL Psychiatry Services PA

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  NC, SC

  Medicare reassignment NPD
• Wholesense Counseling & Consultation, PLLC

  • Clinical Social Worker
  • Concord, NC
  • NPI 1114600202
  NPD Authorized official

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1114104817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7895 WATERWAY DR NW APT 306",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280274436",
            "telephone_number": "828-808-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7895 WATERWAY DR NW APT 306",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280274436",
            "telephone_number": "828-808-4397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Compton Dr",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288062054",
            "country_code": "US",
            "telephone_number": "828-254-5356",
            "fax_number": "828-259-5384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GRACE",
        "middle_name": "KIMBURI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-24",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C008449",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LCSW CERTIFICATION",
            "identifier": "C008449",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassiel Sundiata Sterling Smith, LPCA, LCASA
• Chanao Smith, LCSWA
• Crystal P Smith, COTA/L
• Elecia Nycole Anne Smith
• Elisha John Smith, NP
• Gregory Scott Smith, CRNA
• Harold Truett Smith Jr., PA
• Hope Smith
• Jasmine Janea Smith
• Jenna Smith

• Clinical Social Worker in Concord, NC
• Providers in Concord, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.