Vicki Lynn Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7788-123 Issued in WI

Practice address

3536 52ND St
Kenosha, WI 53144-2662

Phone

(262) 842-0538

Fax

(262) 842-0539

NPI assigned

Jun 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Social Worker

Education

Loyola University of Chicago, Stritch School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kenosha Human Development Services, IncGroup PAC ID 0143467720, 2 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Kenosha Human Development Services, Inc

  • Case Management Agency
  • Kenosha, WI
  • NPI 1942470661
  Medicare reassignment Care Compare group
• Kenosha Human Development Services, Inc

  • Case Management Agency
  • Kenosha, WI
  • NPI 1104622620
  NPD
• Mathew McCarthy, MD, SC

  • Adult Mental Health Clinic/Center
  • Kenosha, WI
  • NPI 1326179987
  NPD (past)

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1265870323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 52ND ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442662",
            "telephone_number": "262-842-0538",
            "fax_number": "262-842-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 52ND ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442662",
            "telephone_number": "262-842-0538",
            "fax_number": "262-842-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "VICKI",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7788-123",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16457132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100030733",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline Marie Smith
• Rachel M Smith, FNP
• Rochelle Smith
• Shawnna Smith
• Susanne Smith, LPC
• Virginia A Smith, MS, LPC
• SNH Wis Tenant LLC (Meadowmere - Southport)
• Rebecca Sobcinski
• Lauren Anne Socha
• Marina Sodagar, P.A.

• Clinical Social Worker in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.