Emily Ricks Smith, LCSW-34678

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW34678 Issued in ID

Practice address

2267 Teton PLZ
Idaho Falls, ID 83404-6486

Phone

(208) 529-1660

Fax

(208) 524-7335

NPI assigned

Jan 25, 2012

Last updated

Jan 15, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1144591934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2267 TETON PLZ",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046486",
            "telephone_number": "208-522-0140",
            "fax_number": "208-524-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2267 TETON PLZ",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046486",
            "telephone_number": "208-529-1660",
            "fax_number": "208-524-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EMILY",
        "middle_name": "RICKS",
        "name_prefix": "Miss",
        "credential": "LCSW-34678",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-25",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW34678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056-0197374",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chance Smith
• Charissa Bethe'L Smith, ATC
• Daniel Philip Wiser Smith, D.O.
• E. Wade Smith, LCSW, LPC
• Emily Smith, LMSW
• Ethan Smith, LMSW
• Golden Thane Smith, O.D.
• Haleigh Smith
• Heather Michele Smith, PTA
• Joshua Michael Smith, M.D.

• Clinical Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.