Active NPI
Cassondra Nicole Smith, LICSW
- Clinical Social Worker
- Boston, MA
National Provider Identifier
1831408194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 119726
- Practice address
- 723 Massachusetts Ave
Boston, MA 02118-2318 - Phone
- (617) 534-9500
- NPI assigned
- Oct 4, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 119726 | MA | Primary |
Addresses
Primary practice location
723 Massachusetts Ave
Boston, MA 02118-2318
Mailing address
1010 Massachusetts Ave
Boston, MA 02118-2600
Phone (617) 419-3408
Other practice location 1
637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110122549A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 6, 2024 through Dec 6, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston Medical Center Corporation | Current | Accepting new patients |
Interoperability endpoints
- csmith181928@direct.bmc.masshiway.net
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1346218294
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713139200000",
"number": "1831408194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 MASSACHUSETTS AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182600",
"telephone_number": "617-419-3408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "723 MASSACHUSETTS AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182318",
"telephone_number": "617-534-9500"
}
],
"practiceLocations": [
{
"address_1": "637 Washington St",
"address_purpose": "LOCATION",
"city": "Dorchester",
"state": "MA",
"postal_code": "021243510",
"country_code": "US",
"telephone_number": "617-825-9660",
"fax_number": "617-288-7898",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "CASSONDRA",
"middle_name": "NICOLE",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-04",
"last_updated": "2024-04-15",
"certification_date": "2024-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "119726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110122549A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.