Jacqueline Nicole Smulevitch, PCSW-1178

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1178 Issued in WY

Practice address

500 S Wolcott St Ste 102
Casper, WY 82601-2882

Phone

(307) 233-2200

NPI assigned

Aug 13, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Casper Family Connections

  • Clinical Psychologist
  • Casper, WY
  • NPI 1609140706
  NPD

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1700617461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S WOLCOTT ST STE 102",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012882",
            "telephone_number": "307-233-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S WOLCOTT ST STE 102",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012882",
            "telephone_number": "307-233-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMULEVITCH",
        "first_name": "JACQUELINE",
        "middle_name": "NICOLE",
        "credential": "PCSW-1178",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "1178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven S Smith, CSW
• Tristen Smith
• Smiths Food & Drug Centers Inc
• Lane Lester Smothers, M.D.
• Laura C Smothers, MD
• Grady King Snyder Jr., M.D.
• Shawn Snyder, DNP, APRN, FNP-C
• Kirsten Lynn Soehn, PCSW
• Alicia Sojourner
• Kimberly Jo Soller, MS, LPC

• Clinical Social Worker in Casper, WY
• Providers in Casper, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.