Lisa Jeanette Smith, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00009464 Issued in WA

Practice address

545 NW Carolyn LN
Poulsbo, WA 98370-9750

Phone

(360) 900-8711

NPI assigned

Apr 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Spirit Horses

  • Clinical Social Worker
  • Poulsbo, WA
  • NPI 1982272266
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1801069596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 NW CAROLYN LN",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709750",
            "telephone_number": "360-900-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 NW CAROLYN LN",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709750",
            "telephone_number": "360-900-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "JEANETTE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013876",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00009464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Joe Smaha, M.S., A.T.C.
• Smartspeidel LLC
• Andrea Dawn Smith, MD
• Kalene Elizabeth Smith, DH
• Le' Roy Smith Jr., CDPT
• Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC
• Sound Family Medicine and Urgent Care PLLC
• Sound Health and Wellness Center Inc.
• Sound Oxygen Service LLC
• Sound Pediatrics, PLLC

• Clinical Social Worker in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.