Active NPI
Evelyn V Smith, LSCSW
- Clinical Social Worker
- Coffeyville, KS
National Provider Identifier
1194005306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4128
- Practice address
- 801 W 8TH St
Coffeyville, KS 67337-4109 - Phone
- (620) 251-4300
- Fax
- (620) 251-4979
- NPI assigned
- Aug 18, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LMSW5111 | KS | |
| Clinical Social Worker | 1041C0700X | 4128 | KS | Primary |
Addresses
Primary practice location
801 W 8TH St
Coffeyville, KS 67337-4109
Mailing address
PO Box 1832
Pittsburg, KS 66762-1832
Phone (620) 231-9873
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4128 | KS | MD | Clinical Social Worker |
| LMSW5111 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672704000000",
"number": "1194005306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1832",
"city": "PITTSBURG",
"state": "KS",
"postal_code": "667621832",
"telephone_number": "620-231-9873",
"fax_number": "620-231-5062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 W 8TH ST",
"city": "COFFEYVILLE",
"state": "KS",
"postal_code": "673374109",
"telephone_number": "620-251-4300",
"fax_number": "620-251-4979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "EVELYN",
"middle_name": "V",
"credential": "LSCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-18",
"last_updated": "2023-01-03",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "LMSW5111",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "4128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coffeyville, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.