Eileen J Smith, LICENSED CLINICAL SO

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW014105 Issued in PA

Practice address

600 N 2ND St Ste 401
Harrisburg, PA 17101-1071

Phone

(860) 788-6404

Fax

(860) 398-6441

NPI assigned

Jan 29, 2007

Last updated

Apr 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Meditelecare of Pennsylvania LLC

  • Clinical Psychologist
  • Harrisburg, PA
  • NPI 1396351847
  NPD

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1245376490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064578095",
            "telephone_number": "860-788-6404",
            "fax_number": "860-398-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N 2ND ST STE 401",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171011071",
            "telephone_number": "860-788-6404",
            "fax_number": "860-398-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EILEEN",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "LICENSED CLINICAL SO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Smith
• Breanna Rose Smith, DC
• Charleene F Smith, CRNP, PMHNP-BC
• David Brian Smith, D.C.
• Deanna S Smith, LPC
• Eric Smith, HIS
• Erik Jon Smith, D.O.
• Erin R Smith, PT, DPT
• G David Smith, PHD
• Jackie Smith, ARNP

• Clinical Social Worker in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.