Active NPI
Shira Smith
- Clinical Social Worker
- Watervliet, NY
National Provider Identifier
1275015471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 101013
- Practice address
- 24 Lakeshore Dr
Watervliet, NY 12189-3015 - Phone
- (518) 944-5123
- NPI assigned
- Sep 4, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 101013 | NY | Primary |
Addresses
Primary practice location
24 Lakeshore Dr
Watervliet, NY 12189-3015
Mailing address
24 Lakeshore Dr
Watervliet, NY 12189-3015
Phone (518) 944-5123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101013 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761782400000",
"number": "1275015471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 LAKESHORE DR",
"city": "WATERVLIET",
"state": "NY",
"postal_code": "121893015",
"telephone_number": "518-944-5123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 LAKESHORE DR",
"city": "WATERVLIET",
"state": "NY",
"postal_code": "121893015",
"telephone_number": "518-944-5123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SHIRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2025-10-30",
"certification_date": "2025-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "101013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watervliet, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.