Lisa Ann Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW00005158 Issued in TN

Practice address

1055 Upchurch Dr
Olive Branch, MS 38654-5575

Phone

(901) 603-1444

NPI assigned

Feb 7, 2007

Last updated

Jun 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lisa.smith.1@30520.direct.athenahealth.com

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1275673337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 UPCHURCH DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386545575",
            "telephone_number": "901-603-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 UPCHURCH DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386545575",
            "telephone_number": "901-603-1444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5515 Shelby Oaks Dr",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381347316",
            "country_code": "US",
            "telephone_number": "901-252-7600 x1278",
            "fax_number": "901-252-7620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "11651-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LCSW00005158",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "CSW0000006936",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Douglas Smith
• Carol Smith, FNP
• Carri Smith, PHARM D
• Julia Lynn Smith, FNP
• Kenyecta D Smith, P-LPC
• Marsheka Varcha Smith, RN
• Mary Elizabeth Smith, P-LPC, LAC
• Robin Powe Smith, PT,DPT
• Southern Pain and Regenerative Medicine PC
• Southern Vascular and Pain Surgery Center Olive Branch LLC

• Clinical Social Worker in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.