Jacquelyn Norry Smith, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R076592 Issued in NY

Practice address

155 W 72ND St RM 701
New York, NY 10023-3262

Phone

(917) 497-2760

NPI assigned

Aug 8, 2012

Last updated

Jan 9, 2026By 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

Opted out of Medicare

Yes, effective Nov 2, 2015 through Nov 2, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1811244817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11117 66TH AVENUE #1B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "617-272-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W 72ND ST RM 701",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100233262",
            "telephone_number": "917-497-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELYN",
        "middle_name": "NORRY",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R076592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Mueller Smith, RN
• Howard Gary Smith, M.D.
• Isaac Smith, DO
• Jaclyn Marie Smith, LCSW
• Jacqueline Carsten Smith, PSYD
• Jake Campbell Smith, MD
• James Dominic Smith, MD
• Jasmine Smith
• Jayleecia Smith
• Jean B. Smith, M.D.

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.