Shirley J Smith, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

C001183 Issued in NC

Practice address

1100 S Mint St
Ste 101
Charlotte, NC 28203-4049

Phone

(704) 379-1850

Fax

(704) 335-1395

NPI assigned

Nov 3, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1780911388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S MINT ST",
            "address_2": "STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034049",
            "telephone_number": "704-379-1850",
            "fax_number": "704-335-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S MINT ST",
            "address_2": "STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034049",
            "telephone_number": "704-379-1850",
            "fax_number": "704-335-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHIRLEY",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-03",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001183",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C001183",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "C001183",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006205",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006204",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shareka Smith
• Shatarra F Smith, PHARMD
• Shelley V Smith
• Shelly Roberta Smith, BSN, RN
• Sherry Finley Smith, FNP
• Stacey Renee Smith
• Stanton James Smith, M.D.
• Stefanie Smith
• Stephanie Smith, BCBA
• Stephanie Denise Smith, LPN

• All providers in Charlotte, NC
• Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.