Individual provider Active NPI

David M. Smyth, LCSW

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1457390023
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
072643-1 Issued in NY
Practice address
26 W 9TH St
Apt 8B
New York, NY 10011-8924
Phone
(201) 805-5528
NPI assigned
Jun 6, 2006
Last updated
Jul 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 072643-1 NY Primary

Addresses

Primary practice location

26 W 9TH St
Apt 8B
New York, NY 10011-8924

Mailing address

17 Beach St
Maplewood, NJ 07040-1313
Phone (201) 805-5528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20040616000538 NY Practitioner - Clinical Social Worker 8224012323 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

71 W 12TH St
Apt 1B
New York, NY 10011-8516
Phone (201) 805-5528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072643-1NYMDMental Health Counselor
065654NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1457390023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BEACH ST",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070401313",
            "telephone_number": "201-805-5528",
            "fax_number": "973-763-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 W 9TH ST",
            "address_2": "APT 8B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118924",
            "telephone_number": "201-805-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTH",
        "first_name": "DAVID",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "072643-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.