Individual provider Active NPI

Kamilah Aisha Smiley

  • Clinical Social Worker
  • Towson, MD
National Provider Identifier
1588136972
Registry record updated Dec 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21077 Issued in MD
Practice address
1055 Taylor Ave Ste 203
Towson, MD 21286-8333
Phone
(443) 279-5829
NPI assigned
Dec 22, 2018
Last updated
Dec 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 21077 MD
Clinical Social Worker 1041C0700X 21077 MD Primary

Addresses

Primary practice location

1055 Taylor Ave Ste 203
Towson, MD 21286-8333

Mailing address

3117 Presbury St
Baltimore, MD 21216-3415
Phone (443) 401-5480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20241017002205 MD Practitioner - Clinical Social Worker 0244762003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Behavioral Health,LLCGroup PAC ID 2961833884, 4 clinicians

Practice addresses (Care Compare)

2519 Maryland Ave
Suite 100
Baltimore, MD 21218-4995
Phone (443) 765-1458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21077MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Behavioral Health,LLC Clinical CurrentSince Oct 1, 2024 Accepting new patients

Locations

2519 Maryland Ave
Ste 100
Baltimore, MD 21218
Phone (443) 288-0098

120 Sister Pierre Dr
Ste 205
Towson, MD 21204
Phone (410) 823-4970

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1545436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545436800000",
    "number": "1588136972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 PRESBURY ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212163415",
            "telephone_number": "443-401-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 TAYLOR AVE STE 203",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212868333",
            "telephone_number": "443-279-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "KAMILAH",
        "middle_name": "AISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-22",
        "last_updated": "2018-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21077",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "21077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.