Samira Desree Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007519 Issued in GA

Practice address

8218 Hazelbrand Rd NE Ste B&C
Covington, GA 30014-1509

Phone

(404) 200-7754

NPI assigned

Mar 23, 2021

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

Other names 1

• Samira Reedy Smith Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1407432990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 FARM LAND CT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300344923",
            "telephone_number": "404-200-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8218 HAZELBRAND RD NE STE B&C",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141509",
            "telephone_number": "404-200-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMIRA",
        "middle_name": "DESREE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contactus@chancecreatinghope.org",
            "affiliation": "Y",
            "endpointDescription": "General Information Secure Email Address",
            "affiliationName": "Creating Hope and Needed Care for Everyone, Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8218 Hazelbrand Rd NE Ste B&c",
            "city": "Covington",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300141509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMIRA",
            "last_name": "REEDY SMITH",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chantiona Nichele Smith
• George Leon Smith III, MD
• Karen Yvonne Smith
• Larissa Smith
• Ryan Kyle Smith, PA-C
• Wendell Smith, MD
• Samia Michelle Solaiman, LCSW
• Southeastern Neurology Associates,LLC
• Southeastern Psychological Associates, Inc
• Erica Spear, RN

• Clinical Social Worker in Covington, GA
• Providers in Covington, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.