NPIMap

Organization Active NPI

Smith Psychotherapy Associates, S.C.

  • Clinical Social Worker
  • Deerfield, IL
National Provider Identifier
1609298702
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149000032 Issued in IL
Legal business name
SMITH PSYCHOTHERAPY ASSOCIATES, S.C.
Practice address
500 Lake Cook Rd Ste 350
Deerfield, IL 60015-5268
Phone
(847) 363-5845
NPI assigned
Jan 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Mr. Robert Joel Smith, LCSW
Title
Owner
Phone
(847) 824-8366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149000032 IL Primary

Addresses

Primary practice location

500 Lake Cook Rd Ste 350
Deerfield, IL 60015-5268

Mailing address

419 Lauren LN
Buffalo Grove, IL 60089-3519
Phone (847) 363-5845

Other practice location 1

241 Golf Mill Ctr
Suite 708
Niles, IL 60714-1224
Phone (847) 824-8366

Other identifiers 1

IdentifierTypeStateIssuer
1114926235OtherILNPI TYPE I

Other names 1

  • Robert J. Smith, LCSW Former legal business name

National Provider Directory

National Provider Directory

Locations

500 Lake Cook Rd
Ste 350
Deerfield, IL 60015
Phone (847) 363-5845

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1609298702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 LAUREN LN",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600893519",
            "telephone_number": "847-363-5845",
            "fax_number": "847-383-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LAKE COOK RD STE 350",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155268",
            "telephone_number": "847-363-5845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 Golf Mill Ctr",
            "address_2": "Suite 708",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "IL",
            "postal_code": "607141224",
            "country_code": "US",
            "telephone_number": "847-824-8366",
            "fax_number": "847-824-8367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SMITH PSYCHOTHERAPY ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-09",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-824-8366",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149000032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE I",
            "identifier": "1114926235",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert J. Smith, LCSW",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Robert J. Smith, LCSW",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.