Individual provider Active NPI

Denise Smith, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1447652375
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008502 Issued in VA
Practice address
289 Independence Blvd
Suite 312
Virginia Beach, VA 23462-5493
Phone
(757) 385-0684
Fax
(757) 493-5456
NPI assigned
Sep 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904008502 VA Primary

Addresses

Primary practice location

289 Independence Blvd
Suite 312
Virginia Beach, VA 23462-5493

Mailing address

297 Independence Blvd
Suite 126
Virginia Beach, VA 23462-2911
Phone (757) 385-0511

Other identifiers 1

IdentifierTypeStateIssuer
1861562472MedicaidVA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904008502VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1447652375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 INDEPENDENCE BLVD",
            "address_2": "SUITE 126",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622911",
            "telephone_number": "757-385-0511",
            "fax_number": "757-473-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 INDEPENDENCE BLVD",
            "address_2": "SUITE 312",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625493",
            "telephone_number": "757-385-0684",
            "fax_number": "757-493-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DENISE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861562472",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.

Verify at the official NPI Registry.