Thomas Michael Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW016654 Issued in PA

Practice address

90 Hope Dr BLDG 1900
Mountain Home Afb, ID 83648

Phone

(208) 828-7580

NPI assigned

May 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1306051065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 OFFUTT RD",
            "city": "HANSCOM AFB",
            "state": "MA",
            "postal_code": "017312634",
            "telephone_number": "570-977-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOPE DR BLDG 1900",
            "city": "MOUNTAIN HOME AFB",
            "state": "ID",
            "postal_code": "83648",
            "telephone_number": "208-828-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW125549",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline A Shafer, LCSW
• Erin Siebert, PHD
• Geremy Skeen, PHARMD
• Joseph Carroll Skinner Jr., CRNA
• Keith A Smith, LMFT
• Dathan J Spinney, IDMT
• Ron Stumbo, RPH
• Jacob Andrew Stutzer, PHARMACIST
• Audrey Nicole Thomas, LCSW
• Sylvia Lashawn Toomer, DENTAL HYGIENIST

• Clinical Social Worker in Mountain Home Afb, ID
• Providers in Mountain Home Afb, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.