Individual provider Active NPI

Darryl Smith Jr., LBSW

  • Social Worker
  • Detroit, MI
National Provider Identifier
1679960488
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802087941 Issued in MI
Practice address
707 W Milwaukee St
Detroit, MI 48202-2943
Phone
(313) 348-3184
Fax
(313) 989-9525
NPI assigned
Apr 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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 6802087941 MI Primary

Addresses

Primary practice location

707 W Milwaukee St
Detroit, MI 48202-2943

Mailing address

707 W Milwaukee St
Detroit, MI 48202-2943
Phone (248) 955-8122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6802087941MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1679960488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W MILWAUKEE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022943",
            "telephone_number": "248-955-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W MILWAUKEE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022943",
            "telephone_number": "313-348-3184",
            "fax_number": "313-989-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DARRYL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LBSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-20",
        "last_updated": "2021-11-15",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802087941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.