Individual provider Active NPI

Jaime Smith

  • Mental Health Counselor
  • Berlin, MD
National Provider Identifier
1184164063
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
22279 Issued in MD
Practice address
9730 Healthway Dr
Berlin, MD 21811-1154
Phone
(410) 629-0164
Fax
(410) 629-0185
NPI assigned
Feb 27, 2017
Last updated
Aug 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 22279 MD Primary

Addresses

Primary practice location

9730 Healthway Dr
Berlin, MD 21811-1154

Mailing address

6040 Public Landing Rd
Snow Hill, MD 21863-2453
Phone (410) 632-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20190829003792 MD Practitioner - Clinical Social Worker 0244568186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9730 Healthway Dr
Berlin, MD 21811-1154
Phone (410) 629-0164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Worcester County Health Department Current Accepting new patients
Worcester County Health Department CurrentSince Jun 19, 2019 Accepting new patients
Worcester County Health Department CurrentSince Jun 19, 2019 Accepting new patients

Locations

9730 Healthway Dr
Berlin, MD 21811
Phone (410) 629-0164

6040 Public Landing Rd
Snow Hill, MD 21863
Phone (410) 629-0041

Organizations & group practices 3

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": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1184164063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 PUBLIC LANDING RD",
            "city": "SNOW HILL",
            "state": "MD",
            "postal_code": "218632453",
            "telephone_number": "410-632-1100",
            "fax_number": "410-632-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 HEALTHWAY DR",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111154",
            "telephone_number": "410-629-0164",
            "fax_number": "410-629-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAIME",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-27",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "22279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.