Delisa Christine Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

67136 Issued in TX

Practice address

211 Saint Clair Dr
Longview, TX 75605-5519

Phone

(903) 387-4268

NPI assigned

Feb 16, 2024

Sex

Female

Sole proprietor

Yes

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

Enrolled in TX

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senior Psychological Care Dallas I LLCGroup PAC ID 3375717044, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Senior Psychological Care Dallas I, LLC

  • Psychologist
  • Houston, TX
  • NPI 1649566795

  Clinical

  Medicare reassignment Care Compare group NPD
• Maverick Therapeutic Solutions

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, TX
  • NPI 1538004478
  NPD Authorized official

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1821853904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SAINT CLAIR DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055519",
            "telephone_number": "903-387-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SAINT CLAIR DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055519",
            "telephone_number": "903-387-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DELISA",
        "middle_name": "CHRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "67136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Jason Smith, MD
• Alexandra Wisdom Smith, APRN, PMHNP-BC
• Alyssa T Smith, DPT
• Carlton Smith, LCDC
• Christina Renee Smith
• Jennifer Nicole Smith, DDS
• Malia Smith
• Mary Beth Smith, CNM
• Mary Bob Smith, LPC
• Michael L. Smith, PA-C

• Clinical Social Worker in Longview, TX
• Providers in Longview, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.