Elizabeth Mae Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L10772 Issued in OR

Practice address

2065 NE Tucson Way Apt 110
Bend, OR 97701-5182

Phone

(541) 383-3005

Fax

(541) 383-1883

NPI assigned

Aug 4, 2014

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 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

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 and National Provider Directory roles.

• Mosaic Community Health

  • Federally Qualified Health Center (FQHC)
  • Prineville, OR
  • NPI 1083633184
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1760891832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4228",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084228",
            "telephone_number": "541-316-6026",
            "fax_number": "541-323-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 NE TUCSON WAY APT 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977015182",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 NW Broadway St Ste B",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977032778",
            "country_code": "US",
            "telephone_number": "541-728-3855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELIZABETH",
        "middle_name": "MAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500700865",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Nichole Smith, RN
• Burl Amber Smith, PSS
• Cameron Phillip Smith
• Daniel Smith, PT.DPT
• Elizabeth Smith, ND, LAC, LMT
• Eric Brian Smith, MD
• Erin Jo Smith
• Evan A Smith, DPM
• Evan Ernest Smith, AAS, LMT
• Gary Bruce Smith, D.C.

• Clinical Social Worker in Bend, OR
• Providers in Bend, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.