Kaitlynn Smith
Individual provider Active NPI Social Worker · Bethalto, IL
NPI 1548003197 · NPPES record last updated Jun 13, 2024
Key facts
- NPI
- 1548003197
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 512 Park Dr
Bethalto, IL 62010-1855 - Phone
- (618) 531-4158
- NPI assigned
- Jun 13, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
512 Park Dr
Bethalto, IL 62010-1855
Mailing address
512 Park Dr
Bethalto, IL 62010-1855
Phone (618) 531-4158
Other providers in Bethalto, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.