Active NPI
Jennifer Smith, LCSW
- Clinical Social Worker
- Lexington, KY
National Provider Identifier
1205226172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3817
- Practice address
- 1101 Veterans Dr
Lexington, KY 40502-2235 - Phone
- (859) 233-4511
- NPI assigned
- Jan 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3817 | KY | Primary |
Addresses
Primary practice location
1101 Veterans Dr
Lexington, KY 40502-2235
Mailing address
4696 Marydale Rd
London, KY 40741-8634
Phone (606) 813-6033
Other practice location 1
4696 Marydale Rd
London, KY 40741-8634
Phone (606) 813-6033
Other practice location 2
56 Marie Langdon Dr
Manchester, KY 40962-6329
Phone (606) 599-4080
Other practice location 3
509 Memorial Dr Ste 2
Manchester, KY 40962-6196
Phone (606) 598-4538
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14396184 | Other | CAQH ID |
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 |
|---|---|---|---|
| 3817 | KY | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552780800000",
"number": "1205226172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4696 MARYDALE RD",
"city": "LONDON",
"state": "KY",
"postal_code": "407418634",
"telephone_number": "606-813-6033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 VETERANS DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405022235",
"telephone_number": "859-233-4511"
}
],
"practiceLocations": [
{
"address_1": "4696 Marydale Rd",
"address_purpose": "LOCATION",
"city": "London",
"state": "KY",
"postal_code": "407418634",
"country_code": "US",
"telephone_number": "606-813-6033",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "56 Marie Langdon Dr",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "KY",
"postal_code": "409626329",
"country_code": "US",
"telephone_number": "606-599-4080",
"fax_number": "606-598-1688",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "509 Memorial Dr Ste 2",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "KY",
"postal_code": "409626196",
"country_code": "US",
"telephone_number": "606-598-4538",
"fax_number": "606-599-2528",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "JENNIFER",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-30",
"last_updated": "2019-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "3817",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH ID",
"identifier": "14396184",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.