Kellie A Smiddie, LISW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

14902 Issued in OH

Practice address

14587 Madison Ave
Lakewood, OH 44107

Phone

(216) 521-5050

Fax

(216) 521-8797

NPI assigned

Aug 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

Practice roles

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.

• Achievement Centers for Children

  • Clinical Social Worker
  • Highland Hills, OH
  • NPI 1841458791
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811005101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14587 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "44107",
            "telephone_number": "216-521-5050",
            "fax_number": "216-521-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14587 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "44107",
            "telephone_number": "216-521-5050",
            "fax_number": "216-521-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIDDIE",
        "first_name": "KELLIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "14902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulette Simonetta, LMT
• Brenda Gail Sims, CDCA
• Jean Marc Sims
• Mary Kathleen Skoch, MD
• Emily Slusarz
• Brian Keith Smith, DDS MD
• Courtney Smith
• Deawna Smith
• Devon Smith, MD
• George Smith, LISW

• Social Worker in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.