Tiffany Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004798 Issued in GA

Practice address

175 Gwinnett Dr
Lawrenceville, GA 30046-8444

Phone

(678) 209-2394

Fax

(678) 212-6343

NPI assigned

Dec 30, 2013

Reactivated

Nov 1, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1508287160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 ASBURY WAY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300582917",
            "telephone_number": "404-906-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 GWINNETT DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468444",
            "telephone_number": "678-209-2394",
            "fax_number": "678-212-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIFFANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-30",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "deactivation_date": "2022-01-10",
        "reactivation_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanita M Smith, R.N.
• Sheila Jeanne Smith, DO
• Sherry Bynum Smith
• Teneshia Smith
• Tiana Nikole Smith, MA CCC SLP
• Tyleeshia Smith
• Whitney Smith, LPC
• William Armour Smith, LMSW
• Snellville Eye Surgery Center LLC
• Stephanie Evelyn Snipes, PHYSICIAN ASSISTANT

• Clinical Social Worker in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.