Mary Olivia Smith, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1601 SW Archer Rd
Gainesville, FL 32608-1135

Phone

(904) 396-8750

NPI assigned

Jan 25, 2017

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1700323904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 CARMICHAEL AVE",
            "address_2": "BUILDING 3300, SUITE 150",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072353",
            "telephone_number": "904-396-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081135",
            "telephone_number": "904-396-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "OLIVIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "SW16181",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH, DIV OF MEDICAL QUALITY ASSURANCE",
            "identifier": "ISW 11471",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Smith
• Mariecia Yvette Smith, LCSW
• Marvisha Lynette Smith, CNA
• Mary Smith
• Mary Beardall Smith, PH.D.
• Maryann Smith
• Maurice Dorian Smith
• Melanie Smith, BCABA
• Melissa Smith, LCSW
• Michael Seth Smith, MD

• Social Worker in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.