Mark L Smith, LPC, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

002326 Issued in MO

Practice address

14825 E 42ND St S
Suite 208
Independence, MO 64055-4776

Phone

(816) 353-5363

Fax

(816) 295-6100

NPI assigned

Dec 16, 2005

Last updated

Aug 25, 2014By 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

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mark Smith, Professional Services, LLC

  • Community/Behavioral Health Agency
  • Independence, MO
  • NPI 1669617627
  Authorized official Same address or phone

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1245216837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 KENWOOD AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641312147",
            "telephone_number": "816-353-5363",
            "fax_number": "816-295-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14825 E 42ND ST S",
            "address_2": "SUITE 208",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640554776",
            "telephone_number": "816-353-5363",
            "fax_number": "816-295-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "LPC, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "000226",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "002326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "A958082",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "34942019",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH",
            "identifier": "34942",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493295521",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  INDIVIDUAL PTAN MA14787001",
            "identifier": "MA14787001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1669617627",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "MA1478",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina Smith, M.S. CCC SLP
• Kevin B Smith
• Kristin Angele Smith, APRN
• Kyle Morgan Smith, PTA
• Marcella Gracette Smith, APRN FNP MSN
• Melody Smith
• Nathaniel J Smith, CF-SLP
• Nicholas Smith, DDS
• Rick E Smith, LPC
• Rose M Smith, LPC

• Clinical Social Worker in Independence, MO
• Providers in Independence, 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 Aug 25, 2014; 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.