Charles Hughie Smith, CSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A5473 Issued in OR

Practice address

3311 NE MLK Jr Blvd Ste 104
Portland, OR 97212-2086

Phone

(503) 946-3484

Fax

(503) 331-2549

NPI assigned

Mar 22, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Shellmire Unlimited, P.C.

  • Community/Behavioral Health Agency
  • Portland, OR
  • NPI 1659793107
  NPD (past)

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1235699596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14120 SE PARMENTER DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972671823",
            "telephone_number": "503-502-2965",
            "fax_number": "503-303-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 NE MLK JR BLVD STE 104",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122086",
            "telephone_number": "503-946-3484",
            "fax_number": "503-331-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "HUGHIE",
        "credential": "CSWA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A5473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Charles.smith@shellmireunlimitedpc.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3311 NE Mlk Jr Blvd Ste 104",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972122086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caroline Catherine Smith
• Carter Smith, CADC II
• Cassandra Smith
• Cassandra Renee Smith
• Catherine Angela Smith, LCSW
• Cheri Ann Smith, RDH
• Christine Smith, PMHNP
• Claire Smith
• Clarissa Smith, L.AC.
• Coleman Smith

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.

Verify at the official NPI Registry.