Dana Lyn Smith, MSW, MHP,LICSW, CMHS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00009250 Issued in WA

Practice address

714 E Edison Ave
Suite B
Sunnyside, WA 98944-2204

Phone

(509) 515-0420

Fax

(509) 515-0422

NPI assigned

Jul 24, 2012

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

Other identifiers 1

Other names 1

• Dana Lyn Fry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1235485509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 E EDISON AVE",
            "address_2": "SUITE B",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442204",
            "telephone_number": "509-515-0420",
            "fax_number": "509-515-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 E EDISON AVE",
            "address_2": "SUITE B",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442204",
            "telephone_number": "509-515-0420",
            "fax_number": "509-515-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANA",
        "middle_name": "LYN",
        "credential": "MSW, MHP,LICSW, CMHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00009250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038375",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "FRY",
            "middle_name": "LYN",
            "credential": "MSW, LICSW, CMHS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David W. Shoemaker Jr., M.D.
• Manavjot Singh Sidhu, MD
• Gregory Alan Simmerman, CCC AUDIOLOGIST
• Sleep Medical Center of Tri-Cities, LLC (Silent Sleep Centers)
• Carolyn Smith
• Matthew Thomas Smith, RPH
• Spavinawdental
• Amy Patricia Sprague, LMP
• Marie Teresa Stanford, MD
• James E Stevens, DR MEDICAL DENTISTRY

• Clinical Social Worker in Sunnyside, WA
• Providers in Sunnyside, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.