Active NPI
Leroy Willie Smith, LCSWC
- Clinical Social Worker
- Baltimore, MD
National Provider Identifier
1366849119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 09174
- Practice address
- 14 S Broadway
Baltimore, MD 21231-1712 - Phone
- (410) 276-1773
- Fax
- (410) 276-2056
- NPI assigned
- Nov 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 09174 | MD | Primary |
Addresses
Primary practice location
14 S Broadway
Baltimore, MD 21231-1712
Mailing address
14 S Broadway
Baltimore, MD 21231-1712
Phone (410) 276-1773
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
| License | State | Type | Specialty |
|---|---|---|---|
| 09174 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416528000000",
"number": "1366849119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 S BROADWAY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212311712",
"telephone_number": "410-276-1773",
"fax_number": "410-276-2056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 S BROADWAY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212311712",
"telephone_number": "410-276-1773",
"fax_number": "410-276-2056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "LEROY",
"middle_name": "WILLIE",
"credential": "LCSWC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-21",
"last_updated": "2014-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "09174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.