Ina F Smith, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R045841-1 Issued in NY

Practice address

20 Kingsbury Ave
Saint Johnsville, NY 13452-1323

Phone

(518) 568-3395

Fax

(518) 568-3395

NPI assigned

Sep 27, 2006

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 NY

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

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124119813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 KINGSBURY AVE",
            "city": "SAINT JOHNSVILLE",
            "state": "NY",
            "postal_code": "134521323",
            "telephone_number": "518-568-3395",
            "fax_number": "518-568-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 KINGSBURY AVE",
            "city": "SAINT JOHNSVILLE",
            "state": "NY",
            "postal_code": "134521323",
            "telephone_number": "518-568-3395",
            "fax_number": "518-568-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "INA",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R045841-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01988283",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oppenheim-Ephratah Central School
• Oppenheim-Ephratah-St.Johnsville CSD
• Performance Therapy and Fitness, LLC
• Shruti Sharma
• Mary Beth Shepardson, OTR
• Susan Anne Smith, RN
• Ranbir S Sodhi, M.D.
• St. Johnsville Area Volunteer Ambulance Corp
• St. Johnsville Central School
• St. Johnsville Rehabilitation and Nursing Center Inc

• Clinical Social Worker in Saint Johnsville, NY
• Providers in Saint Johnsville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.