Keena Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

58581 Issued in TX

Practice address

6310 S State Highway 360
Grand Prairie, TX 75052-8703

Phone

(972) 916-8585

NPI assigned

Jan 24, 2022

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": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1356093918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 S STATE HIGHWAY 360 APT 527",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 S STATE HIGHWAY 360",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528703",
            "telephone_number": "972-916-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breshai Smith
• Christina Williams Smith, RDN
• Farrah E Smith, PT
• Jazmyn Smith
• Joan Smith, NP
• Kristiana Dannielle Smith
• Latonia Shante Smith, DDS
• Regina Chanelle Smith, RN
• Tamiko Smith
• Larry Snow, LCSW

• Clinical Social Worker in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.