Tabitha Smith, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

052448047 Issued in GA

Practice address

165 Cedric St
Leesburg, GA 31763-5027

Phone

(229) 405-1900

Fax

(229) 304-4486

NPI assigned

Sep 5, 2024

Last updated

Sep 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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.

• Gateway Medspa LLC Dba Dana

  dba Dana Inc.

  • Behavior Analyst
  • Leesburg, GA
  • NPI 1609492693
  NPD

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1770318107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MAGNOLIA CT APT A",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317632300",
            "telephone_number": "229-376-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 CEDRIC ST",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317635027",
            "telephone_number": "229-405-1900",
            "fax_number": "229-304-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TABITHA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "052448047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skyler Brooke Simons, DMD
• Derrick Smith
• Kristie Jo Smith, MSN, RN, FNP
• Patrick L Smith, LPC
• Sarah Smith
• Lisa Ritter Speir, CCC-SLP
• Stat Lab Solutions
• Samara Sterling, PHD, RD, DIPACLM
• Lauren Lane Stoklosa, SPEECH PATHOLOGIST
• Steven Joseph Stoklosa, OT R

• Clinical Social Worker in Leesburg, GA
• Providers in Leesburg, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.