Individual provider Active NPI

Lori Latrece Smith, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1578985362
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005057 Issued in GA
Practice address
3103 Clairmont Rd NE
Suite B
Atlanta, GA 30329-1043
Phone
(678) 302-1945
Fax
(404) 601-1386
NPI assigned
Jan 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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 CSW005057 GA Primary

Addresses

Primary practice location

3103 Clairmont Rd NE
Suite B
Atlanta, GA 30329-1043

Mailing address

3103 Clairmont Rd NE
Suite B
Atlanta, GA 30329-1043
Phone (678) 302-1945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160126001392 GA Practitioner - Clinical Social Worker 8729381736 Practice locations: Atlanta, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Atlanta, GA 30331
Phone (404) 401-8429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005057GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1578985362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 CLAIRMONT RD NE",
            "address_2": "SUITE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303291043",
            "telephone_number": "678-302-1945",
            "fax_number": "404-601-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 CLAIRMONT RD NE",
            "address_2": "SUITE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303291043",
            "telephone_number": "678-302-1945",
            "fax_number": "404-601-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LORI",
        "middle_name": "LATRECE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-13",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.