Individual provider Active NPI

Cynthia Ann Clark-Smith, M.S.W

  • Social Worker
  • Syracuse, NY
National Provider Identifier
1447355425
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1044 Issued in KY
Practice address
800 Irving Ave
Syracuse, NY 13210-2716
Phone
(315) 425-4400
Fax
(315) 425-4861
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1044 KY Primary

Addresses

Primary practice location

800 Irving Ave
Syracuse, NY 13210-2716

Mailing address

8513 Bayridge Rd
Cicero, NY 13039-9234
Phone (315) 425-4400

Other names 1

  • Ms. Cynthia Ann Clark Professional name

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

LicenseStateTypeSpecialty
1044KYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447355425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8513 BAYRIDGE RD",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130399234",
            "telephone_number": "315-425-4400",
            "fax_number": "315-425-4861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "315-425-4400",
            "fax_number": "315-425-4861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-SMITH",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.S.W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "1044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "CLARK",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "M.S.W.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.