Individual provider Active NPI

Andrew M Smith, MSW, LISW-S

  • Clinical Social Worker
  • Rocky River, OH
National Provider Identifier
1548524630
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0901471 Issued in OH
Practice address
20525 Center Ridge Rd
Suite 610
Rocky River, OH 44116-3437
Phone
(440) 541-8543
Fax
(877) 737-7658
NPI assigned
Jul 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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 0901471 OH Primary

Addresses

Primary practice location

20525 Center Ridge Rd
Suite 610
Rocky River, OH 44116-3437

Mailing address

20525 Center Ridge Rd
Suite 610
Rocky River, OH 44116-3437
Phone (440) 541-8543

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
0901471OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Babbitt Center for Behavioral Health Clinical Past Accepting new patients

Organizations & group practices 1

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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1548524630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20525 CENTER RIDGE RD",
            "address_2": "SUITE 610",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163437",
            "telephone_number": "440-541-8543",
            "fax_number": "877-737-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20525 CENTER RIDGE RD",
            "address_2": "SUITE 610",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163437",
            "telephone_number": "440-541-8543",
            "fax_number": "877-737-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANDREW",
        "middle_name": "M",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "0901471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.