Individual provider Active NPI

Wanda Smith

  • Clinical Social Worker
  • Bowie, MD
National Provider Identifier
1346626157
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13075 Issued in MD
Practice address
13005 Marthas Choice Cir
Bowie, MD 20720-4704
Phone
(240) 375-6440
NPI assigned
Aug 4, 2015
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X LC50078182 DC
Clinical Social Worker 1041C0700X LC50078182 DC
Clinical Social Worker 1041C0700X 13075 MD Primary

Addresses

Primary practice location

13005 Marthas Choice Cir
Bowie, MD 20720-4704

Mailing address

13005 Marthas Choice Cir
Bowie, MD 20720-4704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20170120000364 MD Order and Referring Only - Clinical Social Worker 5496037830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC50078182DCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jwsmith CurrentSince Oct 4, 2020 Accepting new patients

Organizations & group practices 1

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": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1346626157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 MARTHAS CHOICE CIR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13005 MARTHAS CHOICE CIR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204704",
            "telephone_number": "240-375-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "DC",
            "license": "LC50078182",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078182",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.