Stacey Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2014036758 Issued in MO

Practice address

3009 N Ballas Rd
Building a, Suite 228
Saint Louis, MO 63131-2322

Phone

(314) 750-9441

NPI assigned

Apr 27, 2016

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 9, 2016 through May 9, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1225483274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD",
            "address_2": "BUILDING A, SUITE 228",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-750-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD",
            "address_2": "BUILDING A, SUITE 228",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-750-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STACEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2014036758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Smith, MSW
• Sharon Smith
• Shayla Dana Smith
• Shaylynn Weststeyn Smith, AUD
• Sherea Monica Smith, MD
• Stacey C Smith
• Stacey Lee Smith, MD
• Stephanie Smith
• Stephanie Michelle Smith, LCSW
• Stephen James Smith, D.O.

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.