Apostolic Youth & Family Services

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042301A Issued in IN

Legal business name

APOSTOLIC YOUTH & FAMILY SERVICES

Practice address

4645 Broadway
Gary, IN 46409-2461

Phone

(219) 981-4008

Fax

(219) 981-9273

NPI assigned

Jul 30, 2009

Organization subpart

No

Name

Mr. Clifton Smith, LCSWNPI 1417232414

Title

Executive Director

Phone

(219) 981-4008

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clifton Smith, LCSW

  • Clinical Social Worker
  • Gary, IN
  • NPI 1417232414

  Clinical

  NPD (past) Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 30, 2009.

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1275764896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 BROADWAY",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464092461",
            "telephone_number": "219-981-4008",
            "fax_number": "219-981-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 BROADWAY",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464092461",
            "telephone_number": "219-981-4008",
            "fax_number": "219-981-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOSTOLIC YOUTH & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "219-981-4008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042301A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001842A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Gary, IN
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; 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.