Individual provider Active NPI

Linda A Smith, L.C.S.W.

  • Clinical Social Worker
  • Port St Lucie, FL
National Provider Identifier
1265532956
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7789 Issued in FL
Practice address
2542 SE Welsh St
Port St Lucie, FL 34984-5240
Phone
(772) 871-5546
Fax
(772) 871-5546
NPI assigned
Sep 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW7789 FL Primary
Clinical Social Worker 1041C0700X R057520-01 NY

Addresses

Primary practice location

2542 SE Welsh St
Port St Lucie, FL 34984-5240

Mailing address

2542 SE Welsh St
Port St Lucie, FL 34984-5240
Phone (772) 871-5546

Other identifiers 1

IdentifierTypeStateIssuer
01975415MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110818000514 FL Practitioner - Clinical Social Worker 9234164211 Practice locations: Port St Lucie, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2542 SE Welsh St
Port St Lucie, FL 34984-5240
Phone (772) 871-5546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW7789FLMDClinical Social Worker
R057520-01NYMDClinical Social Worker

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265532956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 SE WELSH ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349845240",
            "telephone_number": "772-871-5546",
            "fax_number": "772-871-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 SE WELSH ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349845240",
            "telephone_number": "772-871-5546",
            "fax_number": "772-871-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LINDA",
        "middle_name": "A",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7789",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R057520-01",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01975415",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.