Individual provider Active NPI

Krista A Smith, MSW, LISW-S

  • Clinical Social Worker
  • Youngstown, OH
National Provider Identifier
1508241605
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1801382-SUPV Issued in OH
Practice address
2980 Belmont Ave
Youngstown, OH 44505-1834
Phone
(330) 759-2310
Fax
(330) 759-0018
NPI assigned
Jul 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S1600352 OH
Clinical Social Worker 1041C0700X I.1801382-SUPV OH Primary

Addresses

Primary practice location

2980 Belmont Ave
Youngstown, OH 44505-1834

Mailing address

2980 Belmont Ave
Youngstown, OH 44505-1834
Phone (330) 759-2310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190215002238 OH Practitioner - Clinical Social Worker 9335487362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psy-Care, Inc.Group PAC ID 9335136795, 29 clinicians

Practice addresses (Care Compare)

2980 Belmont Ave
Youngstown, OH 44505-1834
Phone (330) 759-2310

Merit-based Incentive Payment System (MIPS)

Final score
41.34 of 100Reported as group
Quality
20.12
Improvement activities
0
Cost
84.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1801382-SUPVOHMDClinical Social Worker
S1600352OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psycare, Inc. CurrentSince Feb 5, 2019 Accepting new patients
Psy-Care Inc Clinical CurrentSince Feb 5, 2019 Accepting new patients

Locations

2980 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-0276

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": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1508241605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051834",
            "telephone_number": "330-759-2310",
            "fax_number": "330-759-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051834",
            "telephone_number": "330-759-2310",
            "fax_number": "330-759-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTA",
        "middle_name": "A",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S1600352",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1801382-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.