Caswell Vincent Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

107318 Issued in NY

Practice address

161 California Dr
Rochester, NY 14616-4209

Phone

(585) 290-2224

NPI assigned

Sep 5, 2019

Last updated

Jun 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

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.

• Intentional Impact LMSW PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochester, NY
  • NPI 1154903540
  NPD Authorized official

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1215586920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 CALIFORNIA DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146164209",
            "telephone_number": "585-290-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CALIFORNIA DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146164209",
            "telephone_number": "585-290-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CASWELL",
        "middle_name": "VINCENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-05",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "107318",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "107318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Joyce Smith
• Bridget Patricia Smith
• Brigette Smith, RPA-C
• Brishae Charlese Smith, LPN
• Brynn Smith
• Catherine E Smith III, CPNP/FNP-C
• Chelsea Smith
• Christina Smith
• Christina M Smith, ADVANCED CASAC G
• Christina Marie Smith, L.M.T.

• Clinical Social Worker in Rochester, NY
• Providers in Rochester, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.