Individual provider Active NPI

Charita Nicole Smith, LCSW, MAC

  • Clinical Social Worker
  • Savannah, GA
National Provider Identifier
1831440072
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005645 Issued in GA
Practice address
300 Commercial CT Ste F
Savannah, GA 31406-2676
Phone
(912) 503-5744
Fax
(912) 335-6559
NPI assigned
Sep 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW005401 GA
Clinical Social Worker 1041C0700X CSW005645 GA Primary

Addresses

Primary practice location

300 Commercial CT Ste F
Savannah, GA 31406-2676

Mailing address

700 Commercial CT Ste 102
Savannah, GA 31406-3675
Phone (912) 503-5744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MSW005401GAMDSocial Worker
CSW005645GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Madeleine Shaver, LCSW LLC Clinical PastSince Aug 23, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1831440072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 COMMERCIAL CT STE 102",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063675",
            "telephone_number": "912-503-5744",
            "fax_number": "912-335-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMERCIAL CT STE F",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062676",
            "telephone_number": "912-503-5744",
            "fax_number": "912-335-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARITA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "LCSW, MAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW005401",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.