Individual provider Active NPI

Laura Susan Smith, LMSW

  • Social Worker
  • Jackson, MI
National Provider Identifier
1669970810
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801117718 Issued in MI
Practice address
1200 N West Ave
Jackson, MI 49202-2179
Phone
(517) 783-1200
NPI assigned
Jan 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801117718 MI Primary

Addresses

Primary practice location

1200 N West Ave
Jackson, MI 49202-2179

Mailing address

1200 N West Ave
Jackson, MI 49202-2179

Other practice location 1

1206 Clinton Rd
Jackson, MI 49202-2005
Phone (517) 783-4250

Other names 1

  • Laura Susan Stevens Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240402000423 MI Practitioner - Clinical Social Worker 6002254679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson-Hillsdale Community Mental Health BoardGroup PAC ID 6406808062, 27 clinicians

Practice addresses (Care Compare)

1200 N W Ave
Jackson, MI 49202-2179
Phone (517) 789-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801117718MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson-Hillsdale Community Mental Health Board CurrentSince Mar 4, 2024 Accepting new patients
Jackson-Hillsdale Community Mental Health Board CurrentSince Mar 4, 2024 Accepting new patients

Locations

25 Care Dr
Hillsdale, MI 49242
Phone (517) 439-2641

1200 N West Ave
Jackson, MI 49202
Phone (517) 789-1200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1669970810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-783-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1206 Clinton Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492022005",
            "country_code": "US",
            "telephone_number": "517-783-4250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAURA",
        "middle_name": "SUSAN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801117718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "STEVENS",
            "middle_name": "SUSAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.