Traci Mutzabaugh Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904005929 Issued in VA

Practice address

3580 Forest Haven LN
Suite B
Chesapeake, VA 23321-5134

Phone

(757) 398-2881

Fax

(757) 483-0707

NPI assigned

Jun 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brenda Lee Davis Ma LPC LLCGroup PAC ID 2163840083, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brenda Lee Davis Ma LPC LLC

  • Professional Counselor
  • Chesapeake, VA
  • NPI 1366762270
  Medicare reassignment Care Compare group NPD
• Albemarle Mental Health Center

  • Mental Health Counselor
  • Elizabeth City, NC
  • NPI 1013012400
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477589372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 FOREST HAVEN LN",
            "address_2": "SUITE B",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215134",
            "telephone_number": "757-398-2881",
            "fax_number": "757-483-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 FOREST HAVEN LN",
            "address_2": "SUITE B",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215134",
            "telephone_number": "757-398-2881",
            "fax_number": "757-483-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRACI",
        "middle_name": "MUTZABAUGH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11433361",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Sisson Smith, FNP-C
• Tamara Smith
• Tamara Nicole Smith
• Taron Nicole Smith
• Thedia J Smith, MD
• Smooth Transit, LLC
• Melvin G Snead Jr., LPC, LMFT
• Kendra Snell, BSN
• Nichelle Lavera Snell
• SNG Health Services LLC

• Clinical Social Worker in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Clinical Social Worker in Virginia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.