Active NPI
Kandi Ann Smith-Marlow, LICSW, CCM
- Social Worker
- Williston, VT
National Provider Identifier
1619492790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 097.0127079
- Practice address
- 1375 Maple Street Place
Williston, VT 05495-2555 - Phone
- (802) 316-8444
- NPI assigned
- Aug 9, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 097.0127079 | VT | Primary |
Addresses
Primary practice location
1375 Maple Street Place
Williston, VT 05495-2555
Mailing address
13 S Main St
Jericho, VT 05465-2555
Phone (802) 598-1729
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231013000922 | VT | Practitioner - Clinical Social Worker | 1658726492 | Practice locations: Williston, VT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 097.0127079 | VT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707177600000",
"number": "1619492790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 S MAIN ST",
"city": "JERICHO",
"state": "VT",
"postal_code": "054652555",
"telephone_number": "802-598-1729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1375 MAPLE STREET PLACE",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054952555",
"telephone_number": "802-316-8444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH-MARLOW",
"first_name": "KANDI",
"middle_name": "ANN",
"credential": "LICSW, CCM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-09",
"last_updated": "2024-02-06",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "VT",
"license": "097.0127079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.