Jessica E Smith, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113062 Issued in MA

Practice address

95B Lowell St
Woburn, MA 01801-2245

Phone

(617) 299-1043

NPI assigned

Jan 30, 2009

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 MA

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

Practice roles

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.

• Play, Share, Heal Counseling Services LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Woburn, MA
  • NPI 1083253868
  NPD Authorized official
• DCS Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Medford, MA
  • NPI 1215912894
  NPD (past)

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1215175153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95B LOWELL ST",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012245",
            "telephone_number": "617-835-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95B LOWELL ST",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012245",
            "telephone_number": "617-299-1043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Mystic Ave",
            "address_2": "Suite Six",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "MA",
            "postal_code": "021554632",
            "country_code": "US",
            "telephone_number": "781-396-1199",
            "fax_number": "781-396-1439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "middle_name": "E",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sleepvip
• Tayla Sliney
• Emily Frances Slowik, MSN, CNP
• Anthony Robert Smith, MA
• Bryan Smith, M.A., L.M.H.C.
• Jetta Smith
• Nasya Smith
• Shalesha Smith
• Timothy Herbert Smith, DVM
• HD Hila Snyder, M.A.

• Clinical Social Worker in Woburn, MA
• Providers in Woburn, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.