Individual provider Active NPI

Sheriee D'Lon Smith, LCSW

  • Clinical Social Worker
  • Stuttgart, AR
National Provider Identifier
1609197698
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12827C Issued in AR
Practice address
121 Commercial Dr # B
Stuttgart, AR 72160-7033
Phone
(870) 673-1633
Fax
(870) 673-1253
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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 12827C AR Primary

Addresses

Primary practice location

121 Commercial Dr # B
Stuttgart, AR 72160-7033

Mailing address

2500 Rike Dr
Pine Bluff, AR 71603-3937
Phone (870) 534-1834

Other identifiers 1

IdentifierTypeStateIssuer
301220719MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20230515000771 AR Practitioner - Clinical Social Worker 2769633486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Arkansas Behavioral Healthcare System IncGroup PAC ID 0042292674, 16 clinicians

Practice addresses (Care Compare)

2500 Rike Dr
Pine Bluff, AR 71603-3937
Phone (870) 534-1834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12827CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Arkansas Behavioral Healthcare System Inc CurrentSince May 1, 2023 Accepting new patients
Southeast Arkansas Behavioral Healthcare System Inc PastSince Apr 23, 2023 Accepting new patients

Locations

2500 Rike Dr
Pine Bluff, AR 71603
Phone (870) 534-1834

121 Commercial Dr
#B
Stuttgart, AR 72160
Phone (870) 627-1633

Organizations & group practices 2

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1609197698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 RIKE DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716033937",
            "telephone_number": "870-534-1834",
            "fax_number": "870-534-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 COMMERCIAL DR # B",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "721607033",
            "telephone_number": "870-673-1633",
            "fax_number": "870-673-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHERIEE",
        "middle_name": "D'LON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "12827C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301220719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuttgart, AR

Sources for this page

Verify at the official NPI Registry.