Individual provider Active NPI

William Patrick Smith, LCSW

  • Clinical Social Worker
  • Palm Harbor, FL
National Provider Identifier
1679084958
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3607 Alt 19 Ste B
Palm Harbor, FL 34683-1412
Phone
(727) 422-0996
Fax
(727) 499-7888
NPI assigned
Oct 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

3607 Alt 19 Ste B
Palm Harbor, FL 34683-1412

Mailing address

540 Riverside Dr Ste 8
Salisbury, MD 21801-5352
Phone (410) 548-3333

Other practice location 1

540 Riverside Dr Ste 8
Salisbury, MD 21801-5352
Phone (410) 548-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240430000948 FL Practitioner - Clinical Social Worker 1153761051 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Area Counseling CurrentSince Mar 20, 2024 Accepting new patients
Mindmetrics CurrentSince May 19, 2024 Accepting new patients

Locations

3607 Alt 19
Ste A
Palm Harbor, FL 34683

3607 Alt 19
Palm Harbor, FL 34683
Phone (727) 732-4305

3607 Alt 19
Ste B
Palm Harbor, FL 34683
Phone (727) 422-0996

16502 N Dale Mabry Hwy
Tampa, FL 33618
Phone (727) 732-4305

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": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1679084958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 RIVERSIDE DR STE 8",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015352",
            "telephone_number": "410-548-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 ALT 19 STE B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831412",
            "telephone_number": "727-422-0996",
            "fax_number": "727-499-7888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 Riverside Dr Ste 8",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218015352",
            "country_code": "US",
            "telephone_number": "410-548-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILLIAM",
        "middle_name": "PATRICK",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.