Individual provider Active NPI

Lauren Samantha Smith, LSCSW, RPT

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1508240664
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4918 Issued in KS
Practice address
1421 E 2ND St N
Wichita, KS 67214-4119
Phone
(316) 685-9311
Fax
(316) 633-4283
NPI assigned
Jul 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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 4918 KS Primary

Addresses

Primary practice location

1421 E 2ND St N
Wichita, KS 67214-4119

Mailing address

1421 E 2ND St N
Wichita, KS 67214-4119
Phone (316) 640-2584

Other practice location 1

250 N Rock Rd Ste 110
Wichita, KS 67206-2262
Phone (316) 640-2584

Other identifiers 1

IdentifierTypeStateIssuer
201132160BMedicaidKS

Other names 1

  • L. Samantha Smith 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4918KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Samantha Smith Lscsw RPT Clinical CurrentSince Oct 31, 2021 Accepting new patients
Catholic Charities, Inc. PastSince Jul 27, 2009 Accepting new patients

Locations

250 N Rock Rd
Ste 110
Wichita, KS 67206
Phone (316) 640-2584

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1508240664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 E 2ND ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144119",
            "telephone_number": "316-640-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E 2ND ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144119",
            "telephone_number": "316-685-9311",
            "fax_number": "316-633-4283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 N Rock Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672062262",
            "country_code": "US",
            "telephone_number": "316-640-2584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAUREN",
        "middle_name": "SAMANTHA",
        "credential": "LSCSW, RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201132160B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "L.",
            "last_name": "SMITH",
            "middle_name": "SAMANTHA",
            "credential": "LSCSW, RPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.