Individual provider Active NPI

Kerry Smith, LCSW

  • Clinical Social Worker
  • Raynham, MA
National Provider Identifier
1275083230
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
100 New State Hwy
Raynham, MA 02767-5423
Phone
(781) 666-2711
Fax
(781) 666-2712
NPI assigned
Oct 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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 Primary

Addresses

Primary practice location

100 New State Hwy
Raynham, MA 02767-5423

Mailing address

319 Beech St
Holyoke, MA 01040-3968
Phone (413) 540-1160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210201002530 MA Practitioner - Clinical Social Worker 2769896851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Neuro Behavioral Care LLCGroup PAC ID 2860721362, 57 clinicians

Practice addresses (Care Compare)

61 Lincoln St
Framingham, MA 01702-8264
Phone (781) 666-2711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Neuro Behavioral Care LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

61 Lincoln St
Ste 203
Framingham, MA 01702
Phone (508) 500-6166

100 New State Hwy
Raynham, MA 02767
Phone (781) 666-2711

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1275083230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 BEECH ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010403968",
            "telephone_number": "413-540-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NEW STATE HWY",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027675423",
            "telephone_number": "781-666-2711",
            "fax_number": "781-666-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KERRY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raynham, MA

Sources for this page

Verify at the official NPI Registry.