Kathleen Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19911 Issued in MN

Practice address

1201 Harmon PL
Suite 103
Minneapolis, MN 55403-2043

Phone

(612) 313-3274

Fax

(612) 338-5902

NPI assigned

Feb 13, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1306237268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HARMON PL",
            "address_2": "SUITE 103",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032043",
            "telephone_number": "612-313-3274",
            "fax_number": "612-338-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HARMON PL",
            "address_2": "SUITE 103",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032043",
            "telephone_number": "612-313-3274",
            "fax_number": "612-338-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-13",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Lynne Smith, MT-BC
• Jennifer Lynn Smith, OT
• Jennifer Marie Smith, RN
• Jody Kay Smith, RD,LD,CDE
• Kari Smith, MA
• Katie Jeanne Smith, MA, LADC
• Kaylee Smith
• Kevin Lee Smith, DNP
• Kimberly Kay Smith, PA-C
• Kye Smith

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.