Ebony Lea'Shay Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904018379 Issued in VA

Practice address

18469 Dunne Ave
Parksley, VA 23421

Phone

(757) 665-5041

NPI assigned

May 12, 2025

Last updated

May 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Shore Community MH Mr Sas Services BoardGroup PAC ID 8729185095, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eastern Shore Community MH Mr Sas Services Board

  dba Eastern Shore Behavioral Healthcare Center

  • Professional Counselor
  • Parksley, VA
  • NPI 1154411510
  Medicare reassignment Care Compare group NPD
• Eastern Shore Community Services Board

  • Speech-Language Pathologist
  • Belle Haven, VA
  • NPI 1821283722
  NPD

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1619767654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 318",
            "city": "TASLEY",
            "state": "VA",
            "postal_code": "234410318",
            "telephone_number": "757-442-3636",
            "fax_number": "757-787-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18469 DUNNE AVE",
            "city": "PARKSLEY",
            "state": "VA",
            "postal_code": "23421",
            "telephone_number": "757-665-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EBONY",
        "middle_name": "LEA'SHAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maudene Sherman, LCSW
• Shore Health Services, Inc (Riverside Shore Medical Center at Metompkin)
• Shore Healthcare Group, LLC (Shore Health & Rehab Center)
• Shore Lifecare, Inc.
• Shore Transport Services Inc.
• Deborah K. Van Den Berg, GNP
• Debra Jeanne Wharton, LPC
• Shenay Wharton, LPC,LSATP

• Clinical Social Worker in Parksley, VA
• Providers in Parksley, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.