Shanice Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW006333 Issued in GA

Practice address

9925 International Blvd
Oakland, CA 94603-2558

Phone

(510) 777-1177

NPI assigned

Apr 2, 2018

Last updated

Apr 2, 2018By the provider in NPPES

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

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Roots Community Health CenterGroup PAC ID 8022256007, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Roots Community Health Center

  • Primary Care Clinic/Center
  • Oakland, CA
  • NPI 1083858823
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1548766306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 WALKER AVE APT A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102735",
            "telephone_number": "404-314-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946032558",
            "telephone_number": "510-777-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANICE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rudolph Charles Smith
• Sabrina E. Smith, MD
• Sandra Smith, LCSW
• Sandra Hamiltine Smith, PHD
• Shane Smith
• Sharon Nell Smith, LMFT, MSW
• Shirley Ly Smith, LMFT
• Sonya Audra Smith, LVN
• Stacy Smith, MFT
• Stephanie Smith, LMFT

• Clinical Social Worker in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.