Kelly Smack, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW136943 Issued in PA

Practice address

1526 S Hicks St
Philadelphia, PA 19146-4821

Phone

(267) 540-8675

NPI assigned

May 20, 2020

Sex

Female

Sole proprietor

Yes

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": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1336762707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 S HICKS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464821",
            "telephone_number": "215-275-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 S HICKS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464821",
            "telephone_number": "267-540-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMACK",
        "first_name": "KELLY",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW136943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold P Slutsky, D.M.D.,P.C.
• Jay Slutsky, D.O.
• Lyudmila Emily Slutsky, CRNP
• Samantha Slutsky, DMD
• Valentin Slutsky, PH.D.
• Marc C Smaldone, M.D.
• Rachael Smalfus, ATC
• Calvin Joseph Small, M.D.
• Cherise Small, LCSW
• Conchetta D Small

• Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.