Edward G. Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

320-123 Issued in WI

Practice address

2601 N Martin Luther King Dr
Milwaukee, WI 53212-2711

Phone

(414) 263-8352

Fax

(414) 264-2264

NPI assigned

Jan 16, 2008

Last updated

Jan 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

University of Wisconsin School of Medicine, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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.

• Access Recovery Mental Health Services

  • Community/Behavioral Health Agency
  • Milwaukee, WI
  • NPI 1154786697
  Medicare reassignment NPD
• Matters of the Spirit LLC

  • Clinic/Center
  • Brookfield, WI
  • NPI 1649661711
  Medicare reassignment NPD
• Career Youth Development

  • Addiction (Substance Use Disorder) Counselor
  • Milwaukee, WI
  • NPI 1215195623
  NPD (past)
• Sullivan Medical Clinic, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Milwaukee, WI
  • NPI 1205263159
  NPD (past)
• The Power of Change

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1730477688
  NPD (past)

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1700062155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 N MARTIN LUTHER KING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122711",
            "telephone_number": "414-263-8352",
            "fax_number": "414-264-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDWARD",
        "middle_name": "G.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-16",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "320-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39588700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Ann Smith
• Derek Smith, LCSW
• Desilynn G Smith, MS, LPC, ICS, CSAC
• Diamond Marie Smith
• Dwayne Smith
• Emily Rose Smith, M.D.
• Erika Elaine Smith, PHARM.D.
• Estherlene Denise Smith, M.S. ED, LPC, CSW
• Evelyn ML Smith
• Fredasharron Smith

• Clinical Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.