Individual provider Active NPI

Courtney Smith, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1326384926
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
38696 Issued in TX
Practice address
6363 Harry Hines Blvd 7TH Floor Ste749
Dallas, TX 75390
Phone
(214) 645-8500
Fax
(214) 648-3775
NPI assigned
Dec 31, 2012
Last updated
May 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2019

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 38696 TX Primary

Addresses

Primary practice location

6363 Harry Hines Blvd 7TH Floor Ste749
Dallas, TX 75390

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

Other practice location 1

6363 Harry Hines Blvd 7th Floor Ste749
Dallas, TX 75390
Phone (214) 645-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130509000556 TX Practitioner - Clinical Social Worker 6709023849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6363 Forest Park Rd 7TH FL
749 Univ of TX SW Med Ctr Psych
Dallas, TX 75390-9087
Phone (214) 645-8500

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38696TXMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Assurasource LTD Clinical CurrentSince Mar 4, 2013 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince May 16, 2019 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince May 16, 2019 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

400 N Allen Dr
Ste 204
Allen, TX 75013

12700 Hillcrest Rd
Ste 274
Dallas, TX 75230
Phone 97223310104

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

6363 Frst Park Rd 7th Fl
Ste 749
Dallas, TX 75390
Phone (214) 645-8500

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1326384926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 HARRY HINES BLVD 7TH FLOOR STE749",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75390",
            "telephone_number": "214-645-8500",
            "fax_number": "214-648-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6363 Harry Hines Blvd 7th Floor Ste749",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75390",
            "country_code": "US",
            "telephone_number": "214-645-8500",
            "fax_number": "214-648-3775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COURTNEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-31",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "38696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.