Individual provider Active NPI

Paris Sharice Smith, LICSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1245794379
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50081924 Issued in DC
Practice address
2060 W Virginia Ave NE
Washington, DC 20002-1858
Phone
(202) 636-1190
NPI assigned
Jan 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC50081924 DC Primary

Addresses

Primary practice location

2060 W Virginia Ave NE
Washington, DC 20002-1858

Mailing address

14113 Bowsprit LN Apt 203
Laurel, MD 20707-6329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190404001096 DC Practitioner - Clinical Social Worker 4284975004 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC50081924DCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Capitolhill Consortium for Counseling & Consultation, LLC CurrentSince Mar 1, 2019 Accepting new patients
Mending Minds Mental Health Collective LLC Clinical Current Accepting new patients

Locations

650 Pennsylvania Ave SE
Ste 440
Washington, DC 20003
Phone (202) 644-5440

12150 Annapolis Rd
Ste 309
Glenn Dale, MD 20769
Phone (301) 754-2222

1235 S Clark St
Ste 510
Arlington, VA 22202
Phone (703) 413-3028

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1245794379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14113 BOWSPRIT LN APT 203",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207076329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 W VIRGINIA AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021858",
            "telephone_number": "202-636-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PARIS",
        "middle_name": "SHARICE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50081924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.