Mealani Smith Licensed Clinical Social Worker PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MEALANI SMITH LICENSED CLINICAL SOCIAL WORKER PC

Practice address

9240 Old Redwood Hwy Unit 200
Windsor, CA 95492-9349

Phone

(707) 494-6194

NPI assigned

Jun 26, 2024

Organization subpart

No

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

Authorized official

Name

Mealani M Smith, LCSWNPI 1740803709

Title

Chief Executive Officer

Phone

(707) 494-6194

Specialties & licenses 1

Addresses

Other names 1

• Embodied self therapy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mealani Marie Smith, ASCW

  • Clinical Social Worker
  • Santa Rosa, CA
  • NPI 1740803709
  NPD Authorized official
• Ciera Nicole Perez, AMFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
  • NPI 1255179875
  NPD

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1437994183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 YATES DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054705",
            "telephone_number": "707-494-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9240 OLD REDWOOD HWY UNIT 200",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954929349",
            "telephone_number": "707-494-6194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1023 4th St",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954044301",
            "country_code": "US",
            "telephone_number": "707-494-6194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "328 Yates Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954054705",
            "country_code": "US",
            "telephone_number": "707-494-6194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEALANI SMITH LICENSED CLINICAL SOCIAL WORKER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MEALANI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-494-6194",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embodied self therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Machele Lyons, OD
• Laura A Marcus, FNP
• Mark J. Hagele, DDS, Inc.
• Linda Karen Marshall, P.T.
• James McAleer, RN
• Pamela Anne Meehan Moulton
• Carolyn Miles, OTR/L
• Martin Miller, MAC, LAC, DIP OM
• Kylie Patricia Mitchell, RPH.
• Kurt David Mitchler, D.D.S.

• Clinical Social Worker in Windsor, CA
• Providers in Windsor, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.