Brookelynn Mae Freed Smith, LCSW, MSW, BSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2022038812 Issued in MO

Practice address

712 S Main St
Joplin, MO 64801-4502

Phone

(417) 621-0373

NPI assigned

Aug 24, 2020

Last updated

Sep 30, 2022By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rapha House International Inc

  dba Rapha Hope and Healing Center

  • Clinical Social Worker
  • Joplin, MO
  • NPI 1154191963
  NPD

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1124631882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S MAIN ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648014502",
            "telephone_number": "417-621-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 S MAIN ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648014502",
            "telephone_number": "417-621-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BROOKELYNN",
        "middle_name": "MAE FREED",
        "credential": "LCSW, MSW, BSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2020022699",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2020022699",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022038812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASTER OF SOCIAL WORK LICENSE",
            "identifier": "2020022699",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SOCIAL WORK LICENSE",
            "identifier": "2022038812",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cana D Sluder, MSW, LMSW
• Timothy Small
• Smith Management Services LLC (Family Pharmacy #30)
• Smith Management Services, LLC (Family Pharmacy #18)
• Allison Smith, D.O.
• Carl Henry Smith, FNP-C, PMHNP-BC
• Chance Johnson Smith
• Cora Mae Smith
• David Sean Smith, D.O.
• Debra S. Smith, CRNP

• Clinical Social Worker in Joplin, MO
• Providers in Joplin, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.