Individual provider Active NPI

Whitney Smith, LCSW

  • Clinical Social Worker
  • Suffolk, VA
National Provider Identifier
1760930168
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904011890 Issued in VA
Practice address
424 Market St Ste 100
Suffolk, VA 23434-5249
Phone
(252) 287-5870
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 58-1716970 NC
Clinical Social Worker 1041C0700X P011996 NC
Clinical Social Worker 1041C0700X 0904011890 VA Primary

Addresses

Primary practice location

424 Market St Ste 100
Suffolk, VA 23434-5249

Mailing address

424 Market St Ste 100
Suffolk, VA 23434-5249
Phone (252) 287-5870

Other identifiers 2

IdentifierTypeStateIssuer
1760930168MedicaidNC
1396414413MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20211213001031 VA Practitioner - Clinical Social Worker 8325438096 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58-1716970NCMDCounselor
P011996NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Daughters of Zion Restoration Therapy Inc Clinical CurrentSince Dec 26, 2021 Accepting new patients
Your Business CCC Clinical CurrentSince Oct 1, 2021 Accepting new patients
Teladoc Health Medical Group, P.a. Counselor Current Accepting new patients
Your Business CCC Clinical CurrentSince Mar 24, 2025 Accepting new patients

Locations

157 N Main St
Ste F
Suffolk, VA 23434

424 Market St
Ste 100
Suffolk, VA 23434
Phone (252) 287-5870

Interoperability endpoints

  • Direct secure messaging: whitneysmith@tdh.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1760930168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 MARKET ST STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234345249",
            "telephone_number": "252-287-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 MARKET ST STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234345249",
            "telephone_number": "252-287-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WHITNEY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "58-1716970",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011996",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760930168",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396414413",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.