Kyle S Smith, LBSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6802081145 Issued in MI

Practice address

6051 Frankfort Hwy Ste 200
Benzonia, MI 49616-9651

Phone

(877) 398-2013

Fax

(231) 882-2360

NPI assigned

Feb 15, 2008

Last updated

Feb 15, 2008By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1780852442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7191 FAWN DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496019335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 FRANKFORT HWY STE 200",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496169651",
            "telephone_number": "877-398-2013",
            "fax_number": "231-882-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLE",
        "middle_name": "S",
        "credential": "LBSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802081145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN LICENSE",
            "identifier": "6802081145",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Rubeck, PA
• George B Ryckman, D.O.
• Nicole Shively
• Rob Kenneth Slate, PT, DPT
• Amanda M Smith, MD
• Michelle Smith
• Sarah Smith
• Amy Marie Stein-Hansen, LBSW
• Julie Stevenson
• Jeanne Strathman

• Social Worker in Benzonia, MI
• Providers in Benzonia, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.