Individual provider Active NPI

Robin Marie Smith, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1154457968
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
151 N Michigan Ave
Susite 911
Chicago, IL 60601-7506
Phone
(312) 540-0319
Fax
(312) 540-0315
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

151 N Michigan Ave
Susite 911
Chicago, IL 60601-7506

Mailing address

6116 N Knox Ave
Chicago, IL 60646-5028
Phone (312) 540-0319

Other identifiers 1

IdentifierTypeStateIssuer
1626465OtherILBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149-001948ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Theresa Nollette LCSW LTD Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154457968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 N KNOX AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465028",
            "telephone_number": "312-540-0319",
            "fax_number": "312-540-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N MICHIGAN AVE",
            "address_2": "SUSITE 911",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017506",
            "telephone_number": "312-540-0319",
            "fax_number": "312-540-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBIN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1626465",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.