Individual provider Active NPI

Melody Grace Smith, LCSW-C

  • Clinical Social Worker
  • Elkton, MD
National Provider Identifier
1336970805
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26291 Issued in MD
Practice address
201 Booth St
Elkton, MD 21921-5618
Phone
(443) 466-4623
NPI assigned
Aug 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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 26291 MD Primary

Addresses

Primary practice location

201 Booth St
Elkton, MD 21921-5618

Mailing address

538 Fletchwood Rd
Elkton, MD 21921-3929
Phone (443) 466-4623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26291MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1336970805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 FLETCHWOOD RD",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219213929",
            "telephone_number": "443-466-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BOOTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215618",
            "telephone_number": "443-466-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELODY",
        "middle_name": "GRACE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "26291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.