Jessica Griswold Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C013068 Issued in NC

Practice address

5203 Sharon Rd
Charlotte, NC 28210-4721

Phone

(704) 554-9900

NPI assigned

Jul 7, 2021

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

Medicare fee-for-service enrollment

Enrolled in NC

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

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.

• Presbyterian Samaritan Counseling Center

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1871679464
  Medicare reassignment NPD

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1164093647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5356 COBURG AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282152202",
            "telephone_number": "704-724-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 SHARON RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104721",
            "telephone_number": "704-554-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "middle_name": "GRISWOLD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Smith, RD, LDN
• Jennifer Smith
• Jeralynn Livana Smith
• Jesse Noah Smith
• Jessica Smith, RN
• Jhazmine Khiari Smith
• Jill Smith, C.PED
• Joanna Smith
• Jocelyn Latrice Smith, PHLEBOTOMIST
• John Frank Smith, LCASA

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, 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 Jul 7, 2021; 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.