Danielle Denise Bohannon-Smith

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150113796 Issued in IL

Practice address

417 Anita Dr
Fairview Heights, IL 62208-3641

Phone

(618) 365-3959

NPI assigned

Oct 15, 2026

Last updated

Oct 15, 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

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

{
    "created_epoch": "1792022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1811893043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 ANITA DR",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083641",
            "telephone_number": "618-365-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 ANITA DR",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083641",
            "telephone_number": "618-365-3959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 N Main St Unit 1",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "IL",
            "postal_code": "622361755",
            "country_code": "US",
            "telephone_number": "312-600-8287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHANNON-SMITH",
        "first_name": "DANIELLE",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150113796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.