Robert J. Smith, LCSW,LADC,LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

000405 Issued in CT

Practice address

435 E Main St
Ansonia, CT 06401-1964

Phone

(203) 736-2905

NPI assigned

Nov 12, 2006

Last updated

Jul 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1609947738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 APPLEWOOD DR",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507901",
            "telephone_number": "203-238-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 E MAIN ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064011964",
            "telephone_number": "203-736-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "LCSW,LADC,LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000303",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000405",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "000323",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4183480",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Ansonia, CT
• Providers in Ansonia, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.