Active NPI
Michael Smith, LICSW
- Clinical Social Worker
- Worcester, MA
National Provider Identifier
1598707374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 117423
- Practice address
- 291 Lincoln St
Worcester, MA 01605-3643 - Phone
- (508) 334-3240
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW00841 | RI | |
| Clinical Social Worker | 1041C0700X | ISW01811 | RI | |
| Clinical Social Worker | 1041C0700X | 117423 | MA | Primary |
Addresses
Primary practice location
291 Lincoln St
Worcester, MA 01605-3643
Mailing address
PO Box 415348
Boston, MA 02241
Phone (401) 524-8027
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MS59551 | Medicaid | RI | |
| 1020890 | Other | RI | BEACON/NHP |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CSW00841 | RI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Shore Center Inc | 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": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449705600000",
"number": "1598707374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "02241",
"telephone_number": "401-524-8027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 LINCOLN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016053643",
"telephone_number": "508-334-3240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2015-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "CSW00841",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW01811",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "117423",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MS59551",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON/NHP",
"identifier": "1020890",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.